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Journal of Cancer Research and Clinical Oncology

, Volume 144, Issue 8, pp 1591–1599 | Cite as

End-of-life chemotherapy is associated with poor survival and aggressive care in patients with small cell lung cancer

  • Yingming Zhu
  • Ke Tang
  • Fen Zhao
  • Yuanwei Zang
  • Xiaodong Wang
  • Zhenxiang Li
  • Xindong Sun
  • Jinming Yu
Original Article – Clinical Oncology

Abstract

Background

Concerns regarding end-of-life (EOL) chemotherapy are being increasingly raised. Tumor chemosensitivity may influence the decision for aggressive chemotherapy near the EOL. Data on EOL chemotherapy in highly chemosensitive tumors, such as small cell lung cancer (SCLC), are scarce.

Method

A total of 143 SCLC decedents were consecutively included. Data about clinical factors and treatment modalities were obtained from the electronic medical records. The relationships among EOL chemotherapy, clinical features, overall survival (OS), and aggressive care were investigated.

Results

About 64% of patients had chemosensitive disease. In total, 30.8 and 16.1% of patients received EOL chemotherapy within the last 1 and 2 months of life, respectively. Younger age was associated with a higher rate of EOL chemotherapy. We determined that EOL chemotherapy was related to inferior OS not only in the entire group, but also in the chemosensitive subgroup. Furthermore, more intensive care was observed among patients who underwent EOL chemotherapy compared with those who did not.

Conclusions

EOL chemotherapy was correlated with shorter survival and more aggressive care in patients with SCLC. More research is needed to develop indications for terminating palliative chemotherapy, to help physicians and patients with their difficult choices.

Keywords

Small cell lung cancer (SCLC) End-of-life (EOL) chemotherapy Survival Factor Care 

Notes

Funding

This study was supported by grants from National Health and Family Planning Commission of China (201402011), the National Science Foundation for Young Scientists of China (81602031), the Natural Science Foundation of Shandong Province (ZR201702160004), and Shandong Academy of Medical Sciences (2016-08).

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. A waiver of informed consent was requested, and approval was obtained from the independent Ethics Committees of Shandong Cancer Hospital and Institute, Shandong University.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Radiation Oncology, Shandong Cancer Hospital and InstituteShandong UniversityJinanChina
  2. 2.Department of Radiation OncologyChina-Japan Friendship HospitalBeijingChina
  3. 3.Department of Medical OncologyFourth People’s Hospital of Zibo City, The affiliated Hospital of Shandong Cancer Hospital and InstituteZiboChina
  4. 4.Department of Urology, Qilu HospitalShandong UniversityJinanChina

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