title: Use of chemotherapy at end of life in oncology patients.
abstract: BACKGROUND
  Appropriately timed cessation of chemotherapy is integral to patient's quality of life. We evaluate the use of and associated factors with chemotherapy at the end of life.
  
  
  METHODS
  A review of deceased oncology patients treated with palliative intent from April 2005 over 2 years at two cancer centres was carried out. Chi-square tests of patient demographics, cancer and chemotherapy variables were carried out to determine associations with commencing chemotherapy and continuation within 2 and 4 weeks of death. Multivariate analyses were carried out with significant factors to determine their independent effect.
  
  
  RESULTS
  Seven hundred and forty-seven patients died during this period; median age 67 years (range 20-96); female 44%. Three hundred and ninety-eight (53%) received chemotherapy: 18% and 8% within 4 and 2 weeks of death, respectively. Younger age (P < 0.01), cancer type (P < 0.01) and chemosensitivity of the tumour (P < 0.01) were predictors for commencing chemotherapy in multivariate analysis. Treating doctor predicted for chemotherapy in the 4 weeks before death (<0.05), but none of the variables predicted for chemotherapy in the last 2 weeks of life.
  
  
  CONCLUSIONS
  Younger age, tumour type and chemosensitivity are important predictors of patients receiving palliative chemotherapy. Individual clinician was the only predictor for continuing chemotherapy in the last 4 weeks of life.
authors.affiliation: Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool; Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown; Sydney Cancer Centre, Concord.
authors.forename: S
authors.initials: S
authors.lastname: Kao
authors.affiliation: Collaboration for Cancer Outcomes Research & Evaluation, Liverpool Hospital, Liverpool, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Shafiq
authors.affiliation: Sydney Cancer Centre, Concord.
authors.forename: J
authors.initials: J
authors.lastname: Vardy
authors.affiliation: Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool; Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown. Electronic address: rada6283@bigpond.net.au.
authors.forename: D
authors.initials: D
authors.lastname: Adams
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013727:Terminal Care / Q000379:methods*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents