Supportive Care in Cancer

, Volume 23, Issue 11, pp 3277–3280

Chemotherapy in the last 30 days of life of advanced cancer patients

  • Paola Pacetti
  • Giovanni Paganini
  • Massimo Orlandi
  • Andrea Mambrini
  • M. Cristina Pennucci
  • Alfonso Del Freo
  • Maurizio Cantore
Original Article

Abstract

Purpose

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.

Methods

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.

Results

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 %.

Conclusions

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.

Keywords

Chemotherapy Cancer patients End of life 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Paola Pacetti
    • 1
  • Giovanni Paganini
    • 1
  • Massimo Orlandi
    • 1
  • Andrea Mambrini
    • 1
  • M. Cristina Pennucci
    • 1
  • Alfonso Del Freo
    • 1
  • Maurizio Cantore
    • 2
  1. 1.Oncological DepartmentAzienda USL1 di Massa CarraraCarraraItaly
  2. 2.Oncological departmentPoma HospitalMantovaItaly

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