Integration of Pediatric Palliative Care in Oncology: A Scoping Review

Pediatric palliative care (PPC) enhances quality of life for children with cancer and their families, yet its systematic integration into oncology practice remains limited, particularly in hospital-based care. This scoping review aimed to map and synthesize international evidence on how PPC is designed, implemented, and evaluated in pediatric oncology inpatient settings, and to identify key barriers and facilitators to its clinical integration. Guided by Arksey and O’Malley [1] and the JBI framework [2], we conducted a comprehensive search of MEDLINE, CINAHL, PsycINFO, and Web of Science (2014–2025). Reporting followed PRISMA-ScR standards [3]. Data were charted and narratively synthesized. Thirty-four studies from 18 countries met inclusion criteria. Most employed qualitative methods (n = 12), followed by retrospective chart reviews (n = 7), surveys (n = 4), and reviews or guidelines (n = 11). Evidence revealed delayed initiation of PPC, heterogeneous service models, and limited outcome evaluation. Seven recurrent barriers emerged: absence of standardized models, structural constraints, inadequate staff training, suboptimal communication and family engagement, emotional and cultural barriers, psychosocial strain, and insufficient evaluation frameworks. The findings highlight a global need to integrate early, family-centered PPC within pediatric oncology inpatient care. Health systems should prioritize staff training, establish adaptable interdisciplinary models, and implement structured evaluation strategies to strengthen the quality and consistency of PPC delivery. • Pediatric palliative care (PPC) in pediatric oncology is frequently introduced late and inconsistently across health systems. • Structural barriers—including limited staffing, funding mechanisms, and absent referral pathways—impede timely PPC integration. • International and European standards are unevenly implemented across pediatric oncology services. • European survey data reveal marked heterogeneity in PPC availability and organizational models between countries. • Early, family-centered and systematically evaluated PPC models are urgently needed in pediatric oncology inpatient care.