PURPOSE OF REVIEW: Patients with brain tumours show a high symptom burden, and 
symptoms are difficult to treat and prone to be overlooked. This review of 
publications dealing with advanced stages of brain tumours tries to assess the 
knowledge gained in the past 2 years and to develop an outlook for further 
investigations.
RECENT FINDINGS: We searched for publications on advanced brain tumours in a 
palliative medicine setting. Of 138 publications retrieved by search in PubMed, 
22 publications met our criteria for inclusion. We predefined categories of 
interest: epidemiology and treatment of symptoms; quality of life; and impact on 
next of kin, caregivers, medico-social system and decision-making.
SUMMARY: Data suggest that patients with primary or metastatic brain tumours 
often have a high symptom burden and unmet needs for palliative care, and 
symptoms are hard to diagnose; patients suffer often and early from cognitive 
impairment but are rarely appropriately prepared concerning end-of-life wishes. 
This reflects on their caregivers' burden as well. For symptomatic treatment of 
common symptoms such as fatigue, depression and cognitive impairment, 
methylphenidate has established an important role. For assessment of these 
symptoms, a shortened questionnaire Quality of Life Questionnaire-15-Palliative 
shows potential. Cancer-directed therapy in advanced stages of brain tumours has 
to be weighed critically. To assess adequate strategies to help patients and 
caregivers with the challenges of brain tumour-specific symptoms, randomized 
intervention studies are necessary. The same accounts for cancer-directed 
treatment in relation to quality of life in advanced stages of brain tumours.