Traitements symptomatiques des glioblastomes de stades avancés : un défi thérapeutique

High grade gliomas belong to poor-prognosis cancers. If they are not the most frequent, symptom managements and consequences of the diseases are often complex in practice, with a strong impact on families and caregivers. This case is described in order to illustrate to what extent relieving a patient from the burden of his symptoms might be challenging and to explore the impression of a lack of efficiency when we are brought to treat these symptoms. This report presents the case of a 72-year-old male patient affected by the meningeal scattering of a glioblastoma who was hospitalized in a palliative care unit for the final weeks of his life. Relieving the patient from the burden of his symptoms has proved to be extremely difficult and complex. The results of our bibliographical research about glioblastoma confirm the clinical presentation, its prognosis, the impact on the family and caregivers, but it does not provide specific therapeutic guidance or confirmation about a hypothetical drug resistance. Our case also raises the questions of the physical restraint in a palliative care unit and about the appropriate time of palliative sedation for neurological symptoms. The low frequency of the occurrence of the disease, the heterogeneity of clinical presentations and symptoms etiology account for the lack of evidence. We can only encourage ongoing research in the field of palliative care.