title: Patients who die during palliative radiotherapy. Status survey.
abstract: OBJECTIVE
  Palliative radiotherapy (RT) is routinely used in end of life care of patients with advanced malignancies; however, unnecessarily burdensome treatment shortly before death should be avoided. There is little knowledge on incidence and causes of intercurrent deaths during palliative RT.
  
  
  METHODS
  In this study death events among inpatients receiving palliative RT between January 2009 and December 2011 at this department were retrospectively analyzed. Among epidemiological factors, treatment schedule and chronology, latency and duration of treatment in relation to the actual survival were identified.
  
  
  RESULTS
  In this study 52 patients died during or shortly after palliative RT. Symptomatic bone metastases and brain metastases represented the most common RT indications. The general health status was poor with a median Karnofsky performance score of 50 %, RT was realized with a median single dose of 2.5 Gy to a median total dose of 30.5 Gy and was stopped prematurely in 73 % of patients. On average 53 % of the remaining lifetime was occupied by latency to starting RT. Once RT was begun the treatment duration required a median 64 % of the still remaining lifetime.
  
  
  CONCLUSIONS
  The majority of patients who died had explicitly adverse pre-existing factors and rarely completed RT as scheduled. Latency to RT and RT duration occupied more than half of the remaining lifetime.
authors.affiliation: Department of Radiation Oncology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany, Bernhard.Berger@med.uni-tuebingen.de.
authors.forename: B
authors.initials: B
authors.lastname: Berger
authors.forename: H
authors.initials: H
authors.lastname: Ankele
authors.forename: M
authors.initials: M
authors.lastname: Bamberg
authors.forename: D
authors.initials: D
authors.lastname: Zips
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000532:radiotherapy / Q000556:secondary; D001932:Brain Neoplasms / Q000532:radiotherapy / Q000556:secondary; D005260:Female; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000532:radiotherapy*; D010166:Palliative Care; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016019:Survival Analysis