Background The use of chemotherapy close to the end of the life is not advisable, especially when the probabilities of improvement are limited. The intensity of anticancer treatment at this stage has been suggested as one of the factors influencing quality of life. Data at a European level are scarce, but show signs of overly aggressive treatment.
Purpose To analyse the proportion of patients receiving chemotherapy within the last 2 weeks of life in a Haematology and Oncology setting. To describe the clinical variables of the patients receiving chemotherapy at the end of life, including the type of treatment.
Material and methods A retrospective observational study was conducted in a tertiary hospital. Electronic records were used (HCIS, HospiWin).
Adults aged 18 or older, who died of an onco-haematological neoplasia between 1 April 2017 and 30 March 2018 were included. We assessed the use of chemotherapy over the course of the last 14 days of life, defined as the administration of at least one dose of chemotherapy (including oral targeted therapies and biotherapy). Gender, age, prescribing unit, primary malignancy, last type of treatment (chemotherapy, biotherapy or both), route of administration (parenteral, oral) and temporal interval between the last chemotherapy administration and death of the patient were collected.
For descriptive analysis, the statistical program SPPS version 23.0 was used.
Results A total of 298 patients died between the prespecified period in the Haematology and Oncology units, of whom 60.4% were male, with a median age of 65±13 years (range 30–87). The hospital unit of origin was Oncology for 86.9% (n=259) and Haematology for 13.1% (n=39) of the cases. Tumours with the highest number of deaths were lung (24.4%), breast (15.4%) and colon (9%).
A total of 28.2% (n=11) of haematological and 25.9% (n=67) of oncological patients received chemotherapy during the last 14 days before death. Overall rate was 26.2% (n=78). In these patients, the most widely used therapeutic regimen was classic chemotherapy, administered in 79.5% of patients (67.7% intravenous treatment).
Conclusion The outcomes confirm that the proportion of patients receiving chemotherapy in the last 14 days of life is high, showing excessive aggressiveness at the end-of-life care.
References and/or acknowledgements No conflict of interest.
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