End-of-life palliative chemotherapy: where do we stand?
BACKGROUND
This study evaluates the use of palliative chemotherapy (PCT) and possible associated factors at the end of life.


METHODS
The study includes all advanced non hematological cancer patients who died in the King Abdullah Medical City during the period from January 2011 to April 2014. Demographic and disease features were registered.


RESULTS
420 patients were included in the study, median age 62 years (range 17-108); 52% female and 48% male. 87.4% of patients were Saudis and 12.6% non Saudis. 124 (29.5%) patients received PCT at the last month before death (LM-PCT): 21.8%, 22.6% and 55.6% within one, two and four weeks of death, respectively. Place of death (critical care vs. regular ward) and mode of admission (ER vs. OPD vs. Transferred) had a strong association with LM-PCT (p<0.0001, ϕ=0.35) and (p<0.0001, V=0.43), respectively. There was a gradual increase in the number of patients receiving LM-PCT from January 2011 to April 2014; 15.3%, 28.2%, 37.1% and 19.4%, respectively.


CONCLUSIONS
In our center; at the end of life, there is a gradual increase in the number of patients receiving chemotherapy which significantly increased cancer patients' odds without clear predictive factors associated with its use, which calls into question the benefits of PCT in terminally ill cancer patients.
Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia; Medical Oncology Department, Faculty of Medicine, Zagazig University, Egypt. Electronic address: amrallaabdelmoneem@yahoo.com.
Amrallah A
AA
Mohammed
Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia.
Abdullah S
AS
Al-Zahrani
Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia.
Hafez M
HM
Ghanem
Strategic Planning Department, King Abdullah Medical City-Holy Capital, Saudi Arabia.
Mian U
MU
Farooq
Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia.
Amr M
AM
El Saify
Oncology Center, King Abdullah Medical City-Holy Capital, Saudi Arabia.
Hani M
HM
El-Khatib
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D010166:Palliative Care; D011788:Quality of Life; D012189:Retrospective Studies; D013727:Terminal Care; D055815:Young Adult
D000970:Antineoplastic Agents
End of life; Futile chemotherapy; Palliative chemotherapy