Shuji Hiramoto1, Tomoko Tamaki2, Kengo Nagashima3, Tetsuo Hori4, Ayako Kikuchi4, Akira Yoshioka4, Akira Inoue5. 1. Department of Clinical Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital, Kyoto, Japan. otomari1rx.8@gmail.com. 2. Department of Nursing, Mukogawa Woman's University, Nishinomiya, Japan. 3. The Institute of Statistical Mathematics, Tachikawa, Japan. 4. Department of Clinical Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital, Kyoto, Japan. 5. Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan.
Abstract
BACKGROUND: Clinical efficacy of aggressive end-of-life (EOL) chemotherapy remains unclear. METHOD: Medical records of patients with advanced cancer between August 2011 and August 2016 were retrospectively analyzed. The primary endpoint was to identify prognostic factors at the last administration of chemotherapy. The secondary endpoint was to analyze the relationship between EOL symptoms and EOL treatment details. RESULTS: Among 300 evaluated patients, the number of patients who died within 14 and 30 days from the last administration of chemotherapy were 16 (5.3%) and 50 (16.7%), respectively. Multivariate analysis revealed that ECOG-PS (OR 3.698, p < 0.001) and GPS2 (OR 3.791, p = 0.028) were significant prognostic factors. The MST of patients with both PS 2-4 and GPS2 (+) was 38 days, while that in patients with both PS 0-1 and GPS2 (-) was 134.5 days. The prevalence rate of nausea and vomiting (25.0%) and the mean hydration volume (0.50 L/day) in patients who died within 30 days from the chemotherapy was significantly higher than others (7.4%) (0.20 L/day). CONCLUSION: ECOG-PS and GPS were significant prognostic factors for aggressive EOL chemotherapy. Information on these factors may aid clinical decision-making in terms of risk-benefit balance, particularly in patients with poor prognosis.
BACKGROUND: Clinical efficacy of aggressive end-of-life (EOL) chemotherapy remains unclear. METHOD: Medical records of patients with advanced cancer between August 2011 and August 2016 were retrospectively analyzed. The primary endpoint was to identify prognostic factors at the last administration of chemotherapy. The secondary endpoint was to analyze the relationship between EOL symptoms and EOL treatment details. RESULTS: Among 300 evaluated patients, the number of patients who died within 14 and 30 days from the last administration of chemotherapy were 16 (5.3%) and 50 (16.7%), respectively. Multivariate analysis revealed that ECOG-PS (OR 3.698, p < 0.001) and GPS2 (OR 3.791, p = 0.028) were significant prognostic factors. The MST of patients with both PS 2-4 and GPS2 (+) was 38 days, while that in patients with both PS 0-1 and GPS2 (-) was 134.5 days. The prevalence rate of nausea and vomiting (25.0%) and the mean hydration volume (0.50 L/day) in patients who died within 30 days from the chemotherapy was significantly higher than others (7.4%) (0.20 L/day). CONCLUSION: ECOG-PS and GPS were significant prognostic factors for aggressive EOL chemotherapy. Information on these factors may aid clinical decision-making in terms of risk-benefit balance, particularly in patients with poor prognosis.