Background and importance Many studies have investigated how chemotherapy is used at the end of life but no clear recommendations have been given.
Aim and objectives Analyse treatment aggressiveness and clinical variables of oncohaematologic patients who receive chemotherapy at the end of life.
Material and methods Observational, retrospective study conducted in a secondary hospital during 2020. Inclusion criteria: patients who died in the hospital and were visited by oncologists or haematologists. Variables: demographic, prescription department, diagnosis and stages, last treatment received, administration via, date and performance status on the latest administration and time since the last administration until the patient died. Performance status was measured by the Eastern Cooperative Oncology Group (ECOG) scale. An aggressive treatment was one administrated 14 days before death. Data were collected from electronic health record.
Results Eighty-nine patients were included (64% men, median 71 (IQR 64–78) years). 82 patients were visited by the Oncology Department and 7 by the Haematology Department. Lung cancer (35%) was the most common diagnosis, followed by colorectal cancer (11%) and pancreatic cancer (8%). Other tumours were found in lower percentages. 86.5% of patients were diagnosed with advanced cancer. 71 patients received active treatment (50 intravenous, 13 oral, 3 oral + intravenous and 5 radiotherapy). The most common treatment was chemotherapy (70.4%), followed by immunotherapy (8.5%), radiotherapy (7%) and hormonotherapy (4.2%).
During the last administration 80%–90% of patients had ECOG 1–2 and 19.1% ECOG 3–4. Median days since the last administration until death was 44 (IQR 16–156) days. 19.1% of patients received treatment 14 days before death, 8% a month before death, 21.3% 2 months before death, 5.6% 3 months before death, 25.8% more than 3 months before death and 20.2% did not receive active treatment.
Conclusion and relevance The number of patients who received aggressive treatment was slightly higher than data published in other studies such as Earle et al (2003). Most of the patients belonged to the Oncology Department and had ECOG 1–2, advanced lung cancer being the most common diagnosis and chemotherapy the most common treatment. The main limitation of the study was the non-inclusion of patients who died outside the hospital. It would be interesting to continue this line of investigation.
Conflict of interest No conflict of interest
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.