Aggressive interventions in terminally ill patients with solid tumors in China: a retrospective single center...

Overtreatment in terminally ill cancer patients is very common worldwide, but whether patients will benefit from aggressive care remains obscure. This study aimed to explore the value of aggressive interventions in the end of life in adult patients with advanced solid tumors.

All adult patients who died from advanced solid tumors between 2011 and 2012 in Xiangyang Central Hospital were included. Detailed data concerning cancer types, therapy approach and outcome in the last three months of life were collected and assessed.

263 patients with median age 63 years died of cancer between 2011 and 2012. In the last 3 months of life, 82.5% of the patients received aggressive care, especially chemotherapy and radiotherapy. Traditional Chinese medicine was widely used. Median survival from diagnosis of metastasis to death was 6.9 months for patients treated with aggressive care and 6.2 months for the others, respectively (p>0.05).

Despite their wide use, aggressive interventions in the last 3 months of life might have no benefit on survival. Radiotherapy provided significant symptom palliation of bone or brain metastases, but the short-course radiotherapy schedule was rarely used. Frequent reassessment of patients and making decision together with the patients is helpful to overcome the aggressive care. Appropriate tools to predict survival are needed to help design proper strategies for terminally ill cancer patients.