title: Benefit of palliative chemotherapy and hospice enrollment in late-stage ovarian cancer patients.
abstract: OBJECTIVE
  The ideal timing for transition to best supportive care (BSC) for ovarian cancer patients is not clear. We retrospectively assessed the survival benefit of continuing chemotherapy and hospice enrollment in late-stage ovarian cancer patients.
  
  
  METHODS
  Eligibility criteria included platinum and taxane treatment, clinical progression within 6 months of the last platinum dose, and progression during chemotherapy.
  
  
  RESULTS
  Of the 55 eligible patients (median overall survival after first becoming refractory [1st Ref], 96 days), 22 received chemotherapy (Chemo group), two received radiation therapy, and 13 had medical contraindications for subsequent chemotherapy. The remaining 18 patients (BSC group) were compared with the Chemo group. The Chemo and BSC groups had similar background characteristics, except for the rate of consultation with a regional palliative care physician before or within 1 week of 1st Ref (9% vs 50%, respectively). In multivariate analysis, chemotherapy (hazard ratio 0.251, P = 0.005) and hospice enrollment (hazard ratio, 0.274, P = 0.023) were predictive factors of survival after 1st Ref.
  
  
  CONCLUSIONS
  Chemotherapy after 1st Ref can be offered and hospice enrollment during the terminal stages is encouraged for recurrent ovarian cancer patients.
authors.affiliation: Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsubamoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ito
authors.forename: Riichiro
authors.initials: R
authors.lastname: Kanazawa
authors.forename: Ryu
authors.initials: R
authors.lastname: Wada
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hosoda
authors.forename: Okuto
authors.initials: O
authors.lastname: Honda
authors.forename: Ryu
authors.initials: R
authors.lastname: Takeyama
authors.forename: Riya
authors.initials: R
authors.lastname: Sakane
authors.forename: Yu
authors.initials: Y
authors.lastname: Wakimoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shibahara
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D017051:Hospice Care; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D010166:Palliative Care; D012189:Retrospective Studies
keywords: chemotherapy; hospice; ovarian cancer; palliative care; refractory disease