{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:07:39Z","timestamp":1789564059650,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006058","name":"St. Baldrick's Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006058","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Children with central nervous system (CNS) tumors face high morbidity and mortality, yet often do not receive palliative care (PC). There is evidence of the benefit of PC in pediatric oncology, though the ideal timing remains unknown. We aimed to evaluate the feasibility and acceptability of early PC for children with high\u2010risk CNS tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedures<\/jats:title>\n                    <jats:p>Children at Children's of Alabama with CNS tumors (2019\u20132022) with high mortality risk (e.g., glioblastoma) were referred to PC at the time of diagnosis\/relapse, facilitated by PC and research assistants attending neuro\u2010oncology clinical team meetings. PC aimed to see children within 2\u00a0weeks of index event (IE), then as clinically indicated. For feasibility, we assessed time from IE to PC consult and total PC visits. For acceptability, we conducted semi\u2010structured interviews with parents and clinicians about perceptions of early PC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighteen children (nine female, 14 non\u2010Hispanic White) were eligible. Median IE age was 6\u00a0years (interquartile range [IQR]\u00a0=\u00a02\u201311\u00a0years). All children saw PC; median of 11\u00a0days (IQR\u00a0=\u00a04\u201320\u00a0days) after their IE, with a median of eight (IQR\u00a0=\u00a04\u201320) PC visits. Fourteen parents (11 female, nine non\u2010Hispanic White) and nine clinicians (five physicians, four nurse practitioners) were interviewed. Parents and clinicians reported benefits in symptom management, decisional and family support, and preservation of hope. Clinicians benefited from partnering in complex care and learning PC skills. Notably, caregivers appreciated PC involvement, yet clinicians were anxious about introducing PC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates the feasibility and acceptability of early PC in pediatric neuro\u2010oncology; however, clinician, but not family, discomfort with early PC remains a barrier.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70669","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:35:18Z","timestamp":1789562118000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Palliative Care Is Feasible and Acceptable in Pediatric Neuro\u2010Oncology"],"prefix":"10.1002","author":[{"given":"Gabriel M.","family":"Daniels","sequence":"first","affiliation":[{"name":"Graduate Medicine Education, Heerskink School of Medicine University of Alabamat at Birmingham  Birmingham Alabama USA"},{"name":"Divisions of General Academic Pediatrics and Hospice and Palliative Medicine Morsani College of Medicine University of South Florida  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raba","family":"Tefera","sequence":"additional","affiliation":[{"name":"Institute for Cancer Outcomes and Survivorship, Heersink School of Medicine, University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Martinez","sequence":"additional","affiliation":[{"name":"Institute for Cancer Outcomes and Survivorship, Heersink School of Medicine, University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan I.","family":"Buckingham","sequence":"additional","affiliation":[{"name":"Gerontology, Geriatrics, and Paliative Care, Heersink School of Medicine University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura K.","family":"Metrock","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\/Oncology Heersink School of Medicine University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasha","family":"Ramini","sequence":"additional","affiliation":[{"name":"Children's of Alabama  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smita","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Institute for Cancer Outcomes and Survivorship, Heersink School of Medicine, University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Pediatric Hematology\/Oncology Heersink School of Medicine University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily E.","family":"Johnston","sequence":"additional","affiliation":[{"name":"Institute for Cancer Outcomes and Survivorship, Heersink School of Medicine, University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Pediatric Hematology\/Oncology Heersink School of Medicine University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.106.2.351"},{"key":"e_1_2_8_3_1","unstructured":"World Health Organization \u201cPalliative Care \u201dWHO accessed January 17 2024 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