Back to Search
Start Over
Use of chemotherapy near the end of life: what factors matter?
Use of chemotherapy near the end of life: what factors matter?
- Source :
- Annals of Oncology, Annals of Oncology, 2017, 28 (4), pp.809-817. ⟨10.1093/annonc/mdw654⟩
- Publication Year :
- 2016
-
Abstract
- Background Use of chemotherapy near the end of life in patients with metastatic cancer is often ineffective and toxic. Data about the factors associated with its use remain scarce, especially in Europe. Methods Nationwide, register-based study including all hospitalized patients aged ≥20 years who died from metastatic solid tumors in France between 2010 and 2013. Results A total of 279 846 hospitalized patients who died from metastatic cancer were included. During the last month before death, 19.5% received chemotherapy (including 11.3% during the last 2 weeks). Female sex (OR= 0.96, 95% CI= 0.93–0.98), older age (OR= 0.70, 95% CI= 0.69–0.71 for each 10-year increase) and higher number of chronic comorbidities (OR= 0.83, 95% CI= 0.82–0.84) were independently associated with lower rates of chemotherapy. Although patients with chemosensitive tumors were statistically more likely to receive chemotherapy during the last month before death (OR= 1.21, 1.18–1.25), this association was mostly fueled by testis and ovary tumors and we found no obvious pattern between the expected chemosensitivity of different cancers and the rates of chemotherapy use close to death. Compared with university hospitals, patients who died in for-profit clinics/hospital (OR= 1.40, 95% CI= 1.34–1.45), or comprehensive cancer centers (OR= 1.43, 95% CI= 1.36–1.50) were more likely to receive chemotherapy. Finally, high-volume centers and hospitals without palliative care units reported greater-than-average rates of chemotherapy near the end of life. Conclusion among hospitalized patients with cancer, young individuals, treated in comprehensive cancer centers or in high-volume centers without palliative care units were the most likely to receive chemotherapy near the end of life. We found no evident pattern between the expected chemosensitivity of different cancers and the probability for patients to receive chemotherapy close to death.
- Subjects :
- Oncology
Adult
Male
medicine.medical_specialty
Palliative care
Hospitalized patients
medicine.medical_treatment
[SDV]Life Sciences [q-bio]
Antineoplastic Agents
03 medical and health sciences
0302 clinical medicine
Internal medicine
Neoplasms
medicine
Humans
030212 general & internal medicine
ComputingMilieux_MISCELLANEOUS
Aged
Retrospective Studies
Aged, 80 and over
Chemotherapy
Terminal Care
business.industry
Cancer
Female sex
Hematology
Middle Aged
University hospital
medicine.disease
Ovary tumors
Chemotherapy regimen
[SDV] Life Sciences [q-bio]
030220 oncology & carcinogenesis
Female
business
Subjects
Details
- ISSN :
- 15698041 and 09237534
- Volume :
- 28
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Annals of oncology : official journal of the European Society for Medical Oncology
- Accession number :
- edsair.doi.dedup.....70fc203a258e2ac30d1171483f4b15e0
- Full Text :
- https://doi.org/10.1093/annonc/mdw654⟩