International patterns of palliative care in neuro-oncology: a survey of physician members of the Asian Society for Neuro-Oncology, the European Association of Neuro-Oncology, and the Society for Neuro-Oncology

Abstract Background Brain tumor patients have limited survival and suffer from high morbidity requiring specific symptom management. Specialized palliative care (PC) services have been developed to address these symptoms and provide end-of-life treatment. Global utilization patterns of PC in neuro-oncology are unknown. Methods In a collaborative effort between the Society for Neuro-Oncology (SNO), the European Association of Neuro-Oncology (EANO), and the Asian Society for Neuro-Oncology (ASNO), a 22-question survey was distributed. Wilcoxon 2-sample and Kruskal-Wallis tests were used to assess differences in responses. Results Five hundred fifty-two evaluable responses were received. The most significant differences were found between Asia-Oceania (AO) and Europe as well as AO and United States/Canada (USA-C). USA-C providers had more subspecialty training in neuro-oncology, but most providers had received no or minimal training in palliative care independent of region. Providers in all 3 regions