End-of-life chemotherapy is associated with poor survival and aggressive care in patients with small cell lung cancer

Zhu, Yingming; Tang, Ke; Zhao, Fen; Zang, Yuanwei; Wang, Xiaodong; Li, Zhenxiang; Sun, Xuejun; Yu, Jinming

doi:10.1007/s00432-018-2673-x

Cited by 14 publications

(9 citation statements)

References 28 publications

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“…As death approaches for Chinese patients with terminal cancer, especially in the last 3 months of life, health resources increase substantially to extend life. 5 , 35 , 36 Our study found that patients had greater preference for comfort-oriented care with a high quality of life than in other studies. In 1 study, only 12.0% of patients with cancer in mainland China received palliative care with a high quality of life at EOL, 5 but we found that patients preferred care with a high quality of life.…”

Section: Discussionsupporting

confidence: 40%

Preferences for End-of-Life Care Among Patients With Terminal Cancer in China

et al. 2022

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Section: Discussionsupporting

confidence: 40%

Preferences for End-of-Life Care Among Patients With Terminal Cancer in China

et al. 2022

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“…Another Chinese study found that the proportion of small cell cancer patients receiving chemotherapy in the last month of life was twice as high as in the last two months of life [31]. These data confirm that end-oflife cancer care and cancer deaths in China occurred overwhelmingly in hospital, with only 12% of mainland cancer patients receiving end-of-life palliative care [4].…”

Section: Discussionmentioning

confidence: 74%

Preferences for End-of-life Care among Terminal Cancer Patients in China: A Discrete Choice Experiment

Leng

Maitland

Wang

et al. 2021

Preprint

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Background Knowing terminal cancer patients’ treatment preferences will improve patient-centered health care, better inform surrogates and medical staff of patient preferences and enhance the quality of end-of-life (EoL) care. In China, little is known about terminal cancer patients’ preferences. We aimed to examines the preferences for EoL care of terminal cancer patients. Methods Data on 183 terminal cancer patients aged over 50 years old was collected by discrete choice experiment (DCE). Each DCE scenario described six attributes: hospitalization days,life extension, quality of life (QoL), adverse treatment reactions, place of death preference and out-of-pocket payments.Patient preferences were derived using a mixed logit model and the marginal willingness to pay (WTP) were estimated from the regression coefficients. Results Patients’ preferences for moderate survive time, better quality of life, lower risk of adverse reaction, home death and lower payments were all statistically significant in driving choice between treatment models. Extending life and QoL were the most important attributes. Patients were willing to pay RMB256,895.45 to improve QoL from a bad level to a very good level, significantly higher than their willingness to pay for half additional life year (RMB233,446.16) and one additional life year (RMB182,298.76). This indicates that patients were not willing to blindly pursue life extension and neglect the QoL,but preferred to trade off life extension for QoL. The predicted uptake of optimal end-of-life care scenario was 91.04%. Conclusions Our study contributes to the development of patient-centered preferences for end-of-life care models that improve advanced terminal patient’s care and provide empirical evidence for physicians and surrogates to operationalize end-of-life care trade-offs.

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“…O artigo A3 mostrou que pacientes com câncer avançado que receberam CP precocemente tiveram uma QV melhor do que os pacientes que tiveram acesso a estes cuidados tardiamente. Corroborando com este resultado, estudo (15) realizado na China com pacientes com câncer de pulmão pequenas células avançado, evidenciou que os sintomas com maiores intensidades foram dispneia, anorexia e perda de peso, os quais afetavam negativamente a QV, levando os autores a concluírem que o ideal para estes pacientes é acompanhamento precoce ou exclusivo em CP.…”

Section: -Domínios Que Interferem Na Qualidade De Viverunclassified

<b> Comprometimento da qualidade de vida de pacientes em quimioterapia paliativa e cuidados paliativos: Scoping Review / Life quality assessment of patients in palliative chemotherapy and palliative care: Scoping Review

Lenhani¹,

Tomim²,

Silva³

et al. 2019

Cienc. Cuid. Saúde

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Objetivo: avaliar os domínios que comprometem a qualidade de vida de pacientes com câncer avançado em tratamento quimioterápico paliativo e cuidado paliativo. Método: Trata-se de uma scoping review realizada de março a maio de 2018, nas bases de dados CINAHL, LILACS, PubMed, Cuiden e na literatura cinzenta (Google Scholar e referências encontradas nos artigos analisados), utilizando os descritores “palliative care”,“quality of life”,“emotionalcare”, “functional care”,“sexual care”, “physical care”,“social care”,“comfort care”,“spiritual care”,“palliative chemotherapy” e “cancer advanced”. Foi realizada avaliação da qualidade metodológica por meio do instrumento STROBE para estudos observacionais e o CONSORT para os ensaios clínicos. Resultados: Os nove artigos encontrados e analisados são internacionais, publicados entre 2012 e 2016, com boa qualidade metodológica. Os domínios identificados foram os físicos, sociais e emocionais; o internamento hospitalar e local de óbito são fatores que também comprometeram a qualidade de vida. Conclusão: os pacientes em quimioterapia paliativa possuem baixa qualidade de vida. Porém, a presença de familiar e o acompanhamento concomitante com o serviço de cuidados paliativos melhoram essa situação. A avaliação dos pacientes, com enfoque nestes domínios, permite à Enfermagem adotar estratégias para melhoraria da qualidade de vida.

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End-of-life chemotherapy is associated with poor survival and aggressive care in patients with small cell lung cancer

Abstract: EOL chemotherapy was correlated with shorter survival and more aggressive care in patients with SCLC. More research is needed to develop indications for terminating palliative chemotherapy, to help physicians and patients with their difficult choices.

Cited by 14 publications

References 28 publications

Preferences for End-of-Life Care Among Patients With Terminal Cancer in China

Preferences for End-of-Life Care Among Patients With Terminal Cancer in China

Preferences for End-of-life Care among Terminal Cancer Patients in China: A Discrete Choice Experiment

<b> Comprometimento da qualidade de vida de pacientes em quimioterapia paliativa e cuidados paliativos: Scoping Review / Life quality assessment of patients in palliative chemotherapy and palliative care: Scoping Review

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