title: Palliative chemotherapy during the last month of life.
abstract: BACKGROUND
  This study analyses the potential discriminative characteristics for patients with incurable cancer who received palliative chemotherapy during their last month of life.
  
  
  METHODS
  The study includes all patients with epithelial cancer treated with palliative chemotherapy who died in 2008 in northern Sweden. Demographic parameters and care utilization data were registered. Data were analyzed using nonparametric methods.
  
  
  RESULTS
  Of 374 included patients, 87 (23%) received chemotherapy during the last month of life. These patients had a significantly shorter survival time from first palliative treatment to death, were admitted more frequently to hospital, more often lacked a documented decision to cease treatment, and died less frequently at home.
  
  
  CONCLUSIONS
  The results indicate covariations between palliative chemotherapy treatments in the last month of life and unfavorable patient outcomes. As almost one of four patients with incurable cancer received their last round of palliative chemotherapy <31 days before death, there is a potential for improved routines.
authors.affiliation: The Research and Development Unit, Östersund Hospital, Östersund; Department of Radiation Sciences, University of Umeå, Umeå; Department of Nursing, University of Umeå, Umeå. Electronic address: ulla.nappa@jll.se.
authors.forename: U
authors.initials: U
authors.lastname: Näppä
authors.affiliation: Department of Nursing, University of Umeå, Umeå; Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institute, Stockholm; Research and Development Unit in Palliative Care, Stockholms Sjukhem Foundation, Stockholm, Sweden.
authors.forename: O
authors.initials: O
authors.lastname: Lindqvist
authors.affiliation: Department of Nursing, University of Umeå, Umeå.
authors.forename: B H
authors.initials: BH
authors.lastname: Rasmussen
authors.affiliation: The Research and Development Unit, Östersund Hospital, Östersund; Department of Radiation Sciences, University of Umeå, Umeå.
authors.forename: B
authors.initials: B
authors.lastname: Axelsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000077216:Carcinoma, Ovarian Epithelial; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy* / Q000401:mortality; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality; D010166:Palliative Care / Q000379:methods*; D013548:Sweden / Q000453:epidemiology; D013727:Terminal Care / Q000379:methods*
chemical_list: D000970:Antineoplastic Agents