Chemotherapy in the last 30 days of life of advanced cancer patients
- 392 Downloads
Chemotherapy near the end of life is an issue frequently discussed nowadays, but literature is generally poor. We analyzed patients with cancer who received chemotherapy in their last month of life.
The study involved all patients treated in our oncological department between 2010 and 2012; our attention focused on patients receiving chemotherapy in their last month of life. The hematologic malignancies are excluded.
During the covered period, 2164 pts received chemotherapy, 162 received chemotherapy in their last month of life (24.3 %). The median age of this subgroup was 67.8 years, and median Eastern Cooperative Oncology Group (ECOG) performance status was 2. One hundred and five patients (64.8 %) were males. All patients presented a metastatic disease. Causes of death are as follows: 64.8 % progressive disease, sudden death in 4.9 %, toxicity in 3.1 %, and not available in 27.2 %.
Twenty-four percent of patients treated with chemotherapy received their last regimen within 1 month of death. Percentage is in line with existing results. It is commonly acknowledged that age, performance status, tumor sensitivity, survival prognosis, and comorbidities should be considered in every chemotherapy decision-making; nevertheless, some studies show that age is not a crucial factor. At present, individual clinician is the only predictor for continuing chemotherapy in the last 4 weeks of life. Although appropriateness criteria were applied, patients were submitted to chemotherapy within 1 month of life; we hope that development of simultaneous care could help in end-life decision-making.
KeywordsChemotherapy Cancer patients End of life
Conflict of interest
The authors declare that they have no conflict of interest.
This study was not funded.
- 2.American Society of Clinical Oncology (1996) Outcomes of cancer treatment for technology assessment and cancer treatment guidelines. J Clin Oncol 14:671–679Google Scholar
- 16.Pirovano M, Maltoni M, Nanni O, Marinari M, Indelli M, Zaninetta G, Petrella v, Barni S, Zecca E, Scarpi E, Labianca R, Amadori D, Luporini G (1999) A new palliative prognostic score: a first step for the staging of terminally ill cancer patients. J Pain Symptom Manag 17(4):231–9CrossRefGoogle Scholar
- 17.Maltoni M, Nanni O, Pirovano M, Scarpi E, Indelli m, Martini C, Monti m, Arnoldi E, Piva L, Ravaioli A, Cruciani G, Labianca R, Amadori D (1999) Successful validation of the palliative prognostic score in terminally ill cancer patients. Italian Multicenter Study Group on Palliative Care. J Pain Symptom Manag 17(4):240–7CrossRefGoogle Scholar
- 19.O’Callaghan A, Laking G, Frey R, Robinson J, Gott M (2014) Can we predict which hospitalized patients are in their last year of life? A prospective cross-sectional study of the Gold Standards Framework Prognostic Indicator Guidance as a screening tool in the acute hospital setting. Palliat Med 28(8):1046–52CrossRefPubMedGoogle Scholar