Pediatric Palliative Care: A Retrospective Review from a Tertiary Cancer Center in North-Central India

Abstract Pediatric palliative care (PPC) focuses on enhancing the quality of life for children with serious illnesses and their families; however, timely referral remains limited in resource-constrained settings. This audit was conducted to estimate the prevalence and patterns of PPC referrals at a tertiary cancer center in north-central India. The primary aim is to estimate the prevalence and patterns of PPC consultations among children with cancer at a tertiary cancer center in north-central India. It is a retrospective audit of medical records conducted for pediatric patients (0 to < 18 years) referred to the department of pain and palliative medicine for PPC consultation between January 2021 and June 2024. All analyses were performed using SPSS version 22.0. Out of 2,226 newly registered pediatric patients, 456 (20.5%) were referred to PPC. The referral prevalence increased from 19.8% in 2021 to 22% in 2024. The mean age was 12 years, and hematological malignancies comprised 48.2% of the referrals. The major reasons for referral were best supportive care (31.1%), pain management (30.7%), and counseling (28.3%). Most patients (53.3%) underwent a single follow-up. Teleconsultation (n = 100) and home care (n = 18) services were provided but were underutilized because of logistical issues. The median follow-up was 29 months, with a mean overall survival of 3 months and a 2-year survival rate of 2.1%. Integration of PPC continues to occur late in the illness course, often restricted to symptom-directed support. Implementing structured referral pathways, expanding telemedicine use and home-based models, and providing staff training could make care timelier, more comprehensive, and holistic. Embedding PPC within pediatric oncology can improve symptom control, family coping, and overall quality of life for children with cancer.