Experiences with Prescribing Large Quantities of Systemic Anticancer Therapy Near Death

Baena-Cañada, José Manuel; Bermejo, Alicia Campini; Casado, S. Gamez; Pérez, Lázaro Roque; Cutillas, Alicia Quílez; Candenas, Julio Calvete; Bautista, María José Martínez; Rodríguez, Encarnación Benítez

doi:10.1089/jpm.2019.0017

Cited by 4 publications

(3 citation statements)

References 28 publications

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“…Chemotherapy (ChT) in the last month of life is associated with adverse outcomes including poor quality of care, emergency department attendance, cardiopulmonary resuscitation, mechanical ventilation and with dying in an intensive care unit. 27 Radiotherapy (RT) offers limited benefit for patients with poor PS [e.g. European Cooperative Oncology Group (ECOG) grade 4] and is not recommended in the last month of life.…”

Section: Rationalising Treatmentsmentioning

confidence: 99%

Care of the adult cancer patient at the end of life: ESMO Clinical Practice Guidelines

et al. 2021

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Highlights This ESMO Clinical Practice Guideline provides key recommendations for end-of-life care for patients with advanced cancer. It details care that is focused on comfort, quality of life and approaching death of patients with advanced cancer. All recommendations were compiled by a multidisciplinary group of experts. Recommendations are based on available scientific data and the authors’ collective expert opinion.

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Section: Rationalising Treatmentsmentioning

confidence: 99%

Care of the adult cancer patient at the end of life: ESMO Clinical Practice Guidelines

et al. 2021

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“…9 Recently, Baena-Cañ ada et al showed that 15.3% of patients in an oncological setting in Spain received systemic anticancer therapy in the last 2 weeks of life, and 32.6% did in the last month of life. 10 On the other hand, only 11.3% of patients received chemotherapy in the last 2 weeks of life in a French cohort study. 7 The percentages of patients who started chemotherapy treatment in the last 30 days of life were also much higher than reported in the rest of Europe: ranging from 6.6% to 14%.…”

Section: Discussionmentioning

confidence: 98%

“…5 Despite the scarcity of data at a European level, it seems that end-of-life treatment is aggressive in many cases. [7][8][9][10] The purpose of this study is to analyze the proportion of onco-hematological patients who received chemotherapy within their last 2 weeks of life and the proportion of patients who started a new chemotherapy regimen in the 30 days prior to their death in hospital. The secondary objectives are to describe the clinical variables of those patients receiving chemotherapy in the final stage of their lives and the type of treatment they received.…”

Section: Introductionmentioning

confidence: 99%

Chemotherapy Near the End of Life in Onco–Hematological Adult Patients

Sánchez-Cuervo

García-Basas

Silanes

et al. 2020

Am J Hosp Palliat Care

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Objective: The use of chemotherapy near the end of life is not advisable. There are scarce data in Europe but shows signs of aggressiveness. We designed this study to analyze the proportion of onco–hematological patients receiving chemotherapy within their last 2 weeks of life as well as starting a new chemotherapy regimen in the 30 days prior to death. Methods: A retrospective observational study was conducted in a tertiary hospital. Adults who died of an onco-hematological neoplasia while hospitalized between April 2017 and March 2018 were included. We assessed the use of chemotherapy over the course of the last 14 days of life, defined as the administration of at least one dose of chemotherapy. We also examined the proportion of patients starting a new chemotherapy regimen in the last 30 days of life. Results: A total of 298 inpatients died in the Hematology and Oncology units. During the last 14 days, 28.2% (n = 11) of hematological and 26.3% (n = 68) of oncological patients received chemotherapy; the overall rate was 26.5% (n = 79). Furthermore, the proportion of patients starting a new chemotherapy regimen in the last 30 days of life was high (20.5% and 20.8%, respectively). Female gender (odds ratio [OR] = 1.99, 95% confidence interval [CI] = 1.18-3.35) and age <45 (OR = 2.68, 95% CI = 1.05-6.88) were associated with higher rates of chemotherapy. Conclusion: The proportion of patients receiving chemotherapy in the last 14 days of life was high, as well as the proportion of patients starting a new regimen in their last 30 days. This was indicative of excessive aggressiveness at the end-of-life care.

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