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Prognostic factors in patients who received end-of-life chemotherapy for advanced cancer

  • Shuji Hiramoto
  • Tomoko Tamaki
  • Kengo Nagashima
  • Tetsuo Hori
  • Ayako Kikuchi
  • Akira Yoshioka
  • Akira Inoue
Original Article

Abstract

Background

Clinical efficacy of aggressive end-of-life (EOL) chemotherapy remains unclear.

Method

Medical records of patients with advanced cancer between August 2011 and August 2016 were retrospectively analyzed. The primary endpoint was to identify prognostic factors at the last administration of chemotherapy. The secondary endpoint was to analyze the relationship between EOL symptoms and EOL treatment details.

Results

Among 300 evaluated patients, the number of patients who died within 14 and 30 days from the last administration of chemotherapy were 16 (5.3%) and 50 (16.7%), respectively. Multivariate analysis revealed that ECOG-PS (OR 3.698, p < 0.001) and GPS2 (OR 3.791, p = 0.028) were significant prognostic factors. The MST of patients with both PS 2–4 and GPS2 (+) was 38 days, while that in patients with both PS 0–1 and GPS2 (−) was 134.5 days. The prevalence rate of nausea and vomiting (25.0%) and the mean hydration volume (0.50 L/day) in patients who died within 30 days from the chemotherapy was significantly higher than others (7.4%) (0.20 L/day).

Conclusion

ECOG-PS and GPS were significant prognostic factors for aggressive EOL chemotherapy. Information on these factors may aid clinical decision-making in terms of risk–benefit balance, particularly in patients with poor prognosis.

Keywords

End-of-life Chemotherapy Glasgow Prognostic Score Prognostic factor 

Notes

Compliance with ethical standards

Conflict of interest

All the authors have approved the submission of this manuscript to your journal. There are no conflicts of interest to declare.

Supplementary material

10147_2018_1363_MOESM1_ESM.pptx (54 kb)
Supplementary material 1 (PPTX 54 KB)

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Copyright information

© Japan Society of Clinical Oncology 2018

Authors and Affiliations

  1. 1.Department of Clinical Oncology and Palliative MedicineMitsubishi Kyoto HospitalKyotoJapan
  2. 2.Department of NursingMukogawa Woman’s UniversityNishinomiyaJapan
  3. 3.The Institute of Statistical MathematicsTachikawaJapan
  4. 4.Department of Palliative MedicineTohoku University School of MedicineSendaiJapan

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