M I Santos Pérez1, M Godoy Díez2, C Abajo Del Álamo2. 1. Servicio de Farmacia, Hospital Universitario del Río Hortega, Valladolid, España. Electronic address: marisp243@hotmail.com. 2. Servicio de Farmacia, Hospital Universitario del Río Hortega, Valladolid, España.
Abstract
BACKGROUND: In view of the apparent increase in the aggressiveness of palliative chemotherapy, the purpose of this study was to find out and analyse the characteristics of cancer patients treated in our hospital, and who received chemotherapy near the end of life. PATIENTS AND METHODS: Retrospective, observational study in oncology-haematological patients who received chemotherapy between January 2016 and May 2017, and who died in that same period. Data on sociodemographic and clinical variables were collected. In order to determine the risk factors for receiving chemotherapy in the last month of life, a multivariate logistic regression model was developed and subsequently validated using "bootstrap" re-sampling techniques. RESULTS: A total of 293 patients who received chemotherapy during the study period died. The median time between the last cycle of chemotherapy and death was 52 (0-459) days. Chemotherapy was received in their last month of life in 98 (33.4% of patients. the multivariate analysis indicated that the low chemo-sensitivity of the tumour, the particular medical oncologist, and the fact of dying in the hospital setting, were associated with an increased risk of receiving chemotherapy in the last month of life. CONCLUSIONS: A worrying percentage of patients receive chemotherapy near the end of life. This makes it difficult to receive high-quality palliative care, as well as to die in a familiar environment. It is necessary to review the decision-making process in advanced cancer patients.
BACKGROUND: In view of the apparent increase in the aggressiveness of palliative chemotherapy, the purpose of this study was to find out and analyse the characteristics of cancerpatients treated in our hospital, and who received chemotherapy near the end of life. PATIENTS AND METHODS: Retrospective, observational study in oncology-haematological patients who received chemotherapy between January 2016 and May 2017, and who died in that same period. Data on sociodemographic and clinical variables were collected. In order to determine the risk factors for receiving chemotherapy in the last month of life, a multivariate logistic regression model was developed and subsequently validated using "bootstrap" re-sampling techniques. RESULTS: A total of 293 patients who received chemotherapy during the study period died. The median time between the last cycle of chemotherapy and death was 52 (0-459) days. Chemotherapy was received in their last month of life in 98 (33.4% of patients. the multivariate analysis indicated that the low chemo-sensitivity of the tumour, the particular medical oncologist, and the fact of dying in the hospital setting, were associated with an increased risk of receiving chemotherapy in the last month of life. CONCLUSIONS: A worrying percentage of patients receive chemotherapy near the end of life. This makes it difficult to receive high-quality palliative care, as well as to die in a familiar environment. It is necessary to review the decision-making process in advanced cancerpatients.
Authors: Blanca Prieto-Callejero; Francisco Rivera; Javier Fagundo-Rivera; Adolfo Romero; Macarena Romero-Martín; Juan Gómez-Salgado; Carlos Ruiz-Frutos Journal: Medicine (Baltimore) Date: 2020-08-14 Impact factor: 1.817