Hidekazu Hirano1, Chikako Shimizu2, Asuka Kawachi3, Miwa Ozawa4, Akiko Higuchi5, Saran Yoshida6, Ken Shimizu7, Ryohei Tatara8, Keizo Horibe9. 1. Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan; Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan; Department of Medicine, Keio University Graduate School of Medicine, Tokyo, Japan. 2. Department of Breast Medical Oncology, National Center for Global Health and Medicine, Tokyo, Japan. Electronic address: cshimizu@hosp.ncgm.go.jp. 3. Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan. 4. Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan. 5. Children's Cancer Association of Japan, Tokyo, Japan. 6. Graduate School of Education, Tohoku University, Sendai, Miyagi, Japan. 7. Department of Psycho-oncology, National Cancer Center Hospital, Tokyo, Japan. 8. Department of Psycho-oncology, National Cancer Center Hospital, Tokyo, Japan; Clinical Department of Palliative Medicine, Osaka City General Hospital, Osaka, Japan. 9. Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Abstract
CONTEXT: Patient preferences influence end-of-life (EOL) care which patients receive. However, preferences regarding EOL care among adolescent and young adult (AYA) cancer population remain unclear. OBJECTIVES: The objective of the study was to evaluate preferences regarding EOL care among AYA cancer population. METHODS: We evaluated preferences regarding EOL care as a part of a comprehensive multicenter questionnaire study investigating the experience and needs of Japanese AYA cancer population. RESULTS: A total of 349 AYA cancer population (213 AYA cancer patients and 136 AYA cancer survivors) were evaluated. Eighty-six percent (296/344), 53% (180/338), 88% (301/341), and 61% (207/342) of participants with valid response preferred to have prognostic disclosure, receive palliative chemotherapy for incurable cancer with limited efficacy at the expense of considerable toxicity, actively use palliative care, and stay home at EOL, respectively. In multivariate analysis, the preference regarding prognostic disclosure was associated positively with no child status (odds ratio [OR] = 3.05, P = 0.003) and negatively with history of chemotherapy (OR = 0.23, P = 0.009), the preference regarding palliative chemotherapy for incurable cancer with limited efficacy at the expense of considerable toxicity was associated positively with status under active cancer treatment (OR = 1.74, P = 0.03), and the preference of staying home at EOL was positively associated with anxiety (OR = 1.72, P = 0.04). CONCLUSION: This study elucidated preferences regarding EOL care among Japanese AYA cancer population. These findings may help health care practitioners to have better understanding of preferences regarding EOL care among this population.
CONTEXT: Patient preferences influence end-of-life (EOL) care which patients receive. However, preferences regarding EOL care among adolescent and young adult (AYA) cancer population remain unclear. OBJECTIVES: The objective of the study was to evaluate preferences regarding EOL care among AYA cancer population. METHODS: We evaluated preferences regarding EOL care as a part of a comprehensive multicenter questionnaire study investigating the experience and needs of Japanese AYA cancer population. RESULTS: A total of 349 AYA cancer population (213 AYA cancerpatients and 136 AYA cancer survivors) were evaluated. Eighty-six percent (296/344), 53% (180/338), 88% (301/341), and 61% (207/342) of participants with valid response preferred to have prognostic disclosure, receive palliative chemotherapy for incurable cancer with limited efficacy at the expense of considerable toxicity, actively use palliative care, and stay home at EOL, respectively. In multivariate analysis, the preference regarding prognostic disclosure was associated positively with no child status (odds ratio [OR] = 3.05, P = 0.003) and negatively with history of chemotherapy (OR = 0.23, P = 0.009), the preference regarding palliative chemotherapy for incurable cancer with limited efficacy at the expense of considerable toxicity was associated positively with status under active cancer treatment (OR = 1.74, P = 0.03), and the preference of staying home at EOL was positively associated with anxiety (OR = 1.72, P = 0.04). CONCLUSION: This study elucidated preferences regarding EOL care among Japanese AYA cancer population. These findings may help health care practitioners to have better understanding of preferences regarding EOL care among this population.
Authors: Jeannette Vogt; Franziska Beyer; Jochen Sistermanns; Jonas Kuon; Christoph Kahl; Bernd Alt-Epping; Susanne Stevens; Miriam Ahlborn; Christian George; Andrea Heider; Maria Tienken; Carmen Loquai; Kerstin Stahlhut; Anne Ruellan; Thomas Kubin; Andreas Dietz; Karin Oechsle; Anja Mehnert-Theuerkauf; Birgitt van Oorschot; Michael Thomas; Olaf Ortmann; Christoph Engel; Florian Lordick Journal: Oncologist Date: 2021-03-30