Cancer treatment of severely-III patients not eligible for chemotherapy

Despite having disseminated cancer, not all patients are eligible for palliative chemotherapy or targeted therapies.

To study reasons for withholding palliative chemotherapy, to survey which alternatives were offered and to study survival outcomes.

Medical records of 346 patients with disseminated cancer were collected. Univariate and multivariate statistics were applied.

In total, 48% (n=164) of patients were not offered palliative chemotherapy, mainly depending on diagnosis, age and performance status. Instead, palliative radiotherapy (44%) or endocrine treatments (25%) (breast and prostate cancer) were prescribed. The mean survival for these patients was 216 days, with median survival of only 77 days. In the Cox multivariate analysis survival, prospects were better if the patient was ambulatory and living at home at the first consultation (p<0.01), if performance status was acceptable (p<0.01) and if endocrine treatment was an option (p<0.05).

The prognosis is quite variable, even in cases where palliative chemotherapy is not an option. A hormone-sensitive tumour and a good performance status are significant factors affecting survival in this patient group.