Systemic anticancer therapy near the end of life: an analysis of factors influencing treatment in advanced tumor disease
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View abstract on PubMed
Summary
This summary is machine-generated.Systemic anticancer treatment near end-of-life is common despite toxicity. Treatment type, palliative care access, and performance status significantly influence its use in advanced cancer patients.
Area Of Science
- Oncology
- Palliative Care
- Health Services Research
Background
- Systemic anticancer treatment (SACT) for advanced cancer patients with limited prognosis is often toxic and reduces quality of life.
- Guidelines discourage SACT as low-value care near end-of-life (EOL).
- A significant number of patients still receive SACT within 30 days of death.
Purpose Of The Study
- To investigate the factors influencing the administration of end-of-life (EOL) systemic anticancer treatment (SACT).
- To analyze the characteristics of advanced cancer patients receiving SACT near the end of life.
Main Methods
- Retrospective study of solid tumor patients who died between 2017 and 2021 at University Hospital Krems.
- Analysis focused on the utilization of EOL SACT.
- Statistical analysis identified factors associated with EOL SACT administration.
Main Results
- Of 685 patients, 342 (49.9%) received SACT, and 143 (20.9%) received it within 30 days of death.
- Factors associated with EOL SACT included type of SACT (targeted therapy, chemotherapy/targeted therapy, immune checkpoint inhibitors), no palliative care referral, no palliative care ward admission, and poor ECOG performance status (≥2).
- Median time from last SACT to death was 44.5 days.
Conclusions
- The timing of SACT near EOL is significantly influenced by SACT type, palliative care access, and patient performance status.
- These findings highlight the complexity of EOL treatment decisions in advanced cancer.
- There is a need for personalized, patient-centered approaches considering clinical and patient factors for optimal EOL care.
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