高级别胶质瘤患者对姑息治疗的需求很高，但很少有人接受姑息治疗咨询。根据不同的临床医生样本，本研究旨在探讨以下主题：(1) 初级（由神经肿瘤学家提供）和专业姑息治疗 (SPC) 的益处以及 (2) SPC 转诊的障碍。从 2021 年 9 月到 2023 年 5 月通过有目的抽样招募 10 名姑息治疗医师和 10 名神经肿瘤学家，以实现地理环境、资历和实践结构的多样性。半结构化的 45 分钟访谈由 2 名调查员进行录音、专业转录和编码。采用定性、现象学方法进行主题分析。关于初级姑息治疗，(1) 神经肿瘤学家对癌症定向治疗和姑息治疗拥有主要所有权，(2) 神经肿瘤诊所是神经胶质瘤患者的医疗之家。关于 SPC，(1) 即使没有特定疾病的专业知识，姑息治疗专家的方法也是有益的； (2) 姑息治疗专家有时间全面解决姑息治疗需求； (3)更早的SPC提高了其效益。对于转诊障碍，(1) 可以通过远程医疗、家庭和嵌入式姑息治疗来减轻预约负担； (2) 在高度死亡焦虑的人群中，SPC 与临终关怀之间的耻辱感可以通过及早转诊以促进融洽关系的建立来减轻； (3) 姑息治疗专家缺乏神经肿瘤学专业知识，可以通过强调他们在管理非神经系统症状、应对支持和预期指导方面的作用来缓解。这些主题强调了神经肿瘤学家在解决神经胶质瘤姑息治疗需求方面的核心作用，不排除 SPC 的需要或好处。可能需要定制模型来优化神经胶质瘤初级和专业姑息治疗的平衡。© 作者 2024。由牛津大学出版社代表神经肿瘤学会和欧洲神经肿瘤学会出版。版权所有。如需商业重复使用，请联系 reprints@oup.com 获取转载和转载的翻译权。所有其他权限均可通过我们网站文章页面上的“权限”链接通过我们的 RightsLink 服务获得 - 欲了解更多信息，请联系journals.permissions@oup.com。

Patients with high-grade glioma have high palliative care needs, yet few receive palliative care consultation. This study aims to explore themes on (1) benefits of primary (delivered by neuro-oncologists) and specialty palliative care (SPC) and (2) barriers to SPC referral, according to a diverse sample of clinicians.From September 2021 to May 2023, 10 palliative physicians and 10 neuro-oncologists were recruited via purposive sampling for diversity in geographic setting, seniority, and practice structure. Semistructured, 45-minute interviews were audio-recorded, professionally transcribed, and coded by 2 investigators. A qualitative, phenomenological approach to thematic analysis was used.Regarding primary palliative care, (1) neuro-oncologists have primary ownership of cancer-directed treatment and palliative management and (2) the neuro-oncology clinic is glioma patients' medical home. Regarding SPC, (1) palliative specialists' approach is beneficial even without disease-specific expertise; (2) palliative specialists have time to comprehensively address palliative needs; and (3) earlier SPC enhances its benefits. For referral barriers, (1) appointment burden can be mitigated with telehealth, home-based, and embedded palliative care; (2) heightened stigma associating SPC with hospice in a population with high death anxiety can be mitigated with earlier referral to promote rapport-building; and (3) lack of neuro-oncologic expertise among palliative specialists can be mitigated by emphasizing their role in managing nonneurologic symptoms, coping support, and anticipatory guidance.These themes emphasize the central role of neuro-oncologists in addressing palliative care needs in glioma, without obviating the need for or benefits of SPC. Tailored models may be needed to optimize the balance of primary and specialty palliative care in glioma.© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.