title: The use of palliative chemotherapy in pediatric oncology patients: a national survey of pediatric oncologists.
abstract: BACKGROUND
  Many children continue receiving chemotherapy after there is no realistic hope for cure. One factor that influences parental decisions to pursue medical therapies is physician preference. To date, no studies have described pediatric oncologists' perspectives and practices regarding palliative chemotherapy (PC).
  
  
  METHODS
  We surveyed via email pediatric oncologists practicing in the U.S who are members of the Children's Oncology Group to achieve the following objectives: (1) Describe pediatric oncologists treatment considerations regarding the use of PC. (2) Assess treatment considerations that influenced pediatric oncologists' therapy recommendations for their most recent patient receiving PC. There were 422 participants (40.8%) who completed the survey.
  
  
  RESULTS
  The most important factors considered by pediatric oncologists when prescribing PC were the toxicity of the chemotherapy (4.90 mean SD = 0.36 utilizing 5 point scale with 1 = not important to 5 = very important), the preferences of the family (4.57; SD = 0.60), and the potential to decrease symptoms arising from tumor burden (4.42; SD = 0.65). These treatment considerations were not as important when PC was prescribed for their most recent patient. Similarly, the chief aims in prescribing PC were not achieved for recent patients receiving PC. For their most recent patient who received PC, 40.8% believe this treatment was primarily for parental wishes.
  
  
  CONCLUSIONS
  According to 80.2% of pediatric oncologists completing the survey, some patients receive chemotherapy beyond medical benefit and 40.8% of these oncologists have prescribed PC for the purpose of parental wishes to a recent patient. The chief aims in prescribing palliative chemotherapy were not achieved for recent patients.
authors.affiliation: The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. kang@email.chop.edu
authors.forename: Tammy I
authors.initials: TI
authors.lastname: Kang
authors.forename: Kari
authors.initials: K
authors.lastname: Hexem
authors.forename: Russell
authors.initials: R
authors.lastname: Localio
authors.forename: Richard
authors.initials: R
authors.lastname: Aplenc
authors.forename: Chris
authors.initials: C
authors.lastname: Feudtner
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D010166:Palliative Care