Use of chemotherapy at end of life in oncology patients.
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.
Kao
S
S
Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool; Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown; Sydney Cancer Centre, Concord.
Shafiq
J
J
Collaboration for Cancer Outcomes Research & Evaluation, Liverpool Hospital, Liverpool, Australia.
Vardy
J
J
Sydney Cancer Centre, Concord.
Adams
D
D
Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool; Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown. Electronic address: rada6283@bigpond.net.au.
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
D000970:Antineoplastic Agents