Prevalence of End-of-Life Signs and Symptoms in Glioblastoma Patients: A Descriptive and Retrospective Study
Download PDF


End-of-life signs and symptoms
Palliative care
Nursing care



Submitted : 2023-04-17
Accepted : 2023-05-02
Published : 2023-05-17


Introduction: Glioblastoma is often associated with a poor prognosis. The end-of-life signs and symptoms of these people differ from the rest of the cancer population. Objective: To identify the main signs and symptoms present in the last seven days of life of patients with glioblastoma in a neurological oncology service. Methods: A descriptive and retrospective study was carried out. The sample included patients diagnosed with glioblastoma with medical and nursing records of the last seven days of life that were admitted to the Neurology service and admitted to the institution by the neuro-oncology consultation between 2019 and 2020. Data was collected from the medical records of the patients. Results: Medical records of 17 patients were selected for this study. The main signs and symptoms present in the last seven days of their lives were decreased level of consciousness (94%), rare and unexpected events (94%), respiratory dysfunction (88%), and loss of swallowing ability (76%). Conclusion: The objectives of this study were achieved. However, it is important to conduct studies in this population with more representative samples, since most literature is focused on the oncologic population in general.


Portugal, n.d., viewed April 2021,

Abrey L, Mason W, 2011, Fast Facts: Brain Tumors. Karger Publishers, Basel, 144

Louis D, Perry A, Reifenberger G, et al., 2016, The 2016 World Health Organization Classification if Tumors of the Central Nervous System: A Summary. Acta Neuropathol. 131(6): 803–820.

Bi W, Beroukjim R, 2014, Beating the Odds: Extreme Long-Term Survival with Glioblastoma. Neuro Oncol.,16(9): 1159–1160.

Kuchinad K, Strowd R, Evans A, et al., 2017, End-of-Life Care for Glioblastoma Patients in a Large Academic Center. J Neuro Oncol., 134(1): 75–81.

Tan AC, Ashley DM, López GY, et al., 2020, Management of Glioblastoma: State of the Art and Future Directions. CA Cancer J Clin., 70(4): 299–312.

Le Rhun E, Preusser M, Roth P, et al., 2019, Molecular Targeted Therapy of Glioblastoma. Cancer Treat Rev., 80: 101896.

Persaud-Sharma D, 2018, Cerebral Gliomas: Treatment, Prognosis and Palliative Alternatives. Prog Palliat Care, 26(1): 7–13.

Oronsky B, Reid TR, Oronsky A, et al., 2021, A Review of Newly Diagnosed Glioblastoma. Front Oncol., 10: 574012.

Walbert T, Khan M, 2014, End-of-life Symptoms and Care in Patients with Primary Malignant Brain Tumors: A Systematic Literature Review. J Neurooncol., 117(2): 217–224.

Thier K, Calabek B, Tinchon A, et al., 2016, The Last 10 Days of Patients with Glioblastoma: Assessment of Clinical Signs and Symptoms as well as Treatment. Am J Hosp Palliat Care, 33(10): 1–4.

Crooms R, Goldstein NE, Diamond EL, et al., 2020, Palliative Care in High-Grade Glioma: A Review. Brain Sci, 10(723): 1–26.

Cahill J, Armstrong T, 2011, Caring for an Adult with a Malignant Primary Brain Tumor. Nursing, 41(6): 28–33.

Chaichana K, Halthore A, Parker SL, et al., 2011, Factors Involved in Maintaining Prolonged Functional Independence Following Supratentorial Glioblastoma Resection. J Neurosurg, 114(3): 604–612.

Bergo E, Lombardi G, Guglieri I, et al., 2019, Neurocognitive Functions and Health-Related Quality of Life in Glioblastoma Patients: A Concise Review of the Literature. Eur J Cancer Car, 28(1): e12410.

Capelas M, 2014, Quality Indicators for Palliative Care Services in Portugal, Católica University Press, Lisbon, 286.

Emanuel L, Ferris F, von Gunten C, et al., 2010, The Last Hours of Living: Practical Advice for Clinicians, Medscape Internal Medicine, viewed April 2021,

Sizoo E, Braam L, Postma TJ, et al., 2010, Symptoms and Problems in the End-of-Life Phase of High-Grade Glioma Patients. Neuro Oncol., 12(11): 1162–1166.

Sizoo E, Pasman HRW, Dirven, et al., 2014, The End-of-Life Phase of High-Grade Gliomapatients: A Systematic Review. Support Care Cancer, 22(3): 847–857.

Ross DD, Alexander CS, 2001, Management of Common Symptoms in Terminally Ill Patients: Part I. Fatigue, Anorexia, Cachexia, Nausea and Vomiting. Am Fam Physician, 64(5): 807–814.

Ross DD, Alexander CS, 2001, Management of Common Symptoms in the Terminally Ill: Part II. Am Fam Physician, 64(6): 1019–1026.

Walbert T, 2017, Palliative Care, End-of-Life Care, and Advance Care Planning in Neuro-Oncology. Continuum (MinneapMinn), 23(6): 1709–1726.

Koekkoek J, Sizoo EM, Pasman HRW, 2014, Symptoms and Medication Management in the End-of-Life Phase of High-Grade Glioma Patients. JNeurooncol, 120(3): 589–595.