Dataset Information

Chemotherapy Near the End of Life for Chinese Patients with Solid Malignancies.

ABSTRACT:

Introduction

There are increasing concerns about the negative impacts of chemotherapy near the end of life (EOL). There is discrepancy among different countries about its use, and little is known about the real-world situation in China.

Patients and methods

This retrospective study was conducted at six representative hospitals across China. Adult decedents with a record of advanced solid cancer and palliative chemotherapy were consecutively screened from 2010 through 2014. The prevalence of EOL chemotherapy within the last 1 month of life was set as the primary outcome. The correlations among EOL chemotherapy, clinicopathological features, and overall survival (OS) were investigated.

Results

A total of 3,350 decedents who had had cancer were consecutively included; 2,098 (62.6%) were male and the median age was 56 years (range, 20-88). There were 177 (5.3%), 387 (11.6%), and 837 (25.0%) patients who received EOL chemotherapy within the last 2 weeks, 1 month, and 2 months of life, respectively. We identified inferior OS (median OS, 7.1 vs. 14.2 months; hazard ratio, 1.37; 95% confidence interval [CI], 1.23-1.53; p < .001), more intensive treatments (e.g., admitted to intensive care unit [ICU] in the last month of life, received cardiopulmonary resuscitation and invasive ventilation support), and hospital death (odds ratio, 1.53; 95% CI, 1.14-2.06; p?=?.005) among patients who received continued chemotherapy within the last month compared with those who did not. However, subgroup analyses indicated that receiving oral agents correlated with fewer ICU admissions and lower rates of in-hospital death.

Conclusion

This study showed that EOL chemotherapy is commonly used in China. Intravenous chemotherapy at the EOL significantly correlated with poor outcomes and the role of oral anticancer agents warrants further investigation. The Oncologist 2017;22:53-60Implications for Practice: The role of chemotherapy toward the end of life (EOL) in patients with solid cancers is debatable. This article is believed to be the first to report the current prevalence of EOL chemotherapy in China. This study found that, compared with oral anticancer agents, intravenous chemotherapy at the EOL was significantly associated with poor outcomes. Therefore, the role of oral anticancer agents at the EOL stage deserves further investigation.

SUBMITTER: Sheng J

PROVIDER: S-EPMC5313269 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Chemotherapy Near the End of Life for Chinese Patients with Solid Malignancies.

Sheng Jin J Zhang Ya-Xiong YX He Xiao-Bo XB Fang Wen-Feng WF Yang Yun-Peng YP Lin Gui-Nan GN Wu Xuan X Li Ning N Zhang Jing J Zhai Lin-Zhu LZ Zhao Yuan-Yuan YY Huang Yan Y Zhou Ning-Ning NN Zhao Hong-Yun HY Zhang Li L

The oncologist 20161027 1

<h4>Introduction</h4>There are increasing concerns about the negative impacts of chemotherapy near the end of life (EOL). There is discrepancy among different countries about its use, and little is known about the real-world situation in China.<h4>Patients and methods</h4>This retrospective study was conducted at six representative hospitals across China. Adult decedents with a record of advanced solid cancer and palliative chemotherapy were consecutively screened from 2010 through 2014. The pre ...[more]

PMID: 27789776

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Dataset Information

Chemotherapy Near the End of Life for Chinese Patients with Solid Malignancies.

Introduction

Patients and methods

Results

Conclusion

Publications

Chemotherapy Near the End of Life for Chinese Patients with Solid Malignancies.

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