Background and importance Palliative care can improve the quality of life in patients with advanced cancer. However, WHO data indicate that only 14% of people who need palliative assistance take advantage of it.
Aim and objectives To evaluate therapeutic aggressiveness near the end of life in patients with metastatic non-microcytic lung cancer (mNSCLC) and implementation of palliative care in hospital.
Material and methods This was a retrospective observational study in a tertiary hospital. All adult patients diagnosed with mNSCLC who received intravenous antineoplastic treatment in 2018 and died of cancer were included. Patients were followed from admission until 30 August 2019 or death. To define therapeutic aggressiveness near the end of life we used the criteria of Earle et al. Demographic and clinical parameters were collected from the medical history: age, gender, diagnosis date, ECOG, treatment line, the first and last day of administration, date and place of death and quality variables at the end of life (emergency care, hospital admission in the last month of life, assistance by the palliative care unit and admission to the intensive care unit (ICU) in the last month of life).
Results A total of 36 patients were evaluated. Mean age was 65 (SD 9.7) years, 78% were men, 61% of patients had ECOG ≥2, 19% received three or more lines of treatment and 37.8% were treated with chemotherapy and 22,2% with immunotherapy.
Therapeutic aggressiveness criteria:
2.8% received antineoplastic treatment in the last 14 days of life (aggressiveness limit ≥10%).
8.3% started a new antineoplastic treatment in the last 30 days of life (limit ≥2%).
41.7% sought emergency care at least once or were admitted to the ICU during the last month of life (limit ≥4%).
25.0% received palliative care (limit <55%). Type of follow–up: 77.8% inpatients and 22.2% outpatients.
80.5% died in the intensive care unit (limit ≥17%).
Conclusion and relevance The data revealed no excessive use of antineoplastic treatment at the end of life (Earle et al criteria). However, the percentage of patients who died in hospital was high. In addition, our results reflect the lack of palliative care among terminally ill patients with mNSCLC. This supports the need for greater implementation of palliative care in hospital.
References and/or acknowledgements No conflict of interest.
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