title: Chemotherapy in the last 30 days of life of advanced cancer patients.
abstract: OBJECTIVE
  Chemotherapy near the end of life is an issue frequently discussed nowadays, but literature is generally poor. We analyzed patients with cancer who received chemotherapy in their last month of life.
  
  
  METHODS
  The study involved all patients treated in our oncological department between 2010 and 2012; our attention focused on patients receiving chemotherapy in their last month of life. The hematologic malignancies are excluded.
  
  
  RESULTS
  During the covered period, 2164 pts received chemotherapy, 162 received chemotherapy in their last month of life (24.3 %). The median age of this subgroup was 67.8 years, and median Eastern Cooperative Oncology Group (ECOG) performance status was 2. One hundred and five patients (64.8 %) were males. All patients presented a metastatic disease. Causes of death are as follows: 64.8 % progressive disease, sudden death in 4.9 %, toxicity in 3.1 %, and not available in 27.2 %.
  
  
  CONCLUSIONS
  Twenty-four percent of patients treated with chemotherapy received their last regimen within 1 month of death. Percentage is in line with existing results. It is commonly acknowledged that age, performance status, tumor sensitivity, survival prognosis, and comorbidities should be considered in every chemotherapy decision-making; nevertheless, some studies show that age is not a crucial factor. At present, individual clinician is the only predictor for continuing chemotherapy in the last 4 weeks of life. Although appropriateness criteria were applied, patients were submitted to chemotherapy within 1 month of life; we hope that development of simultaneous care could help in end-life decision-making.
authors.affiliation: Oncological Department, Azienda USL1 di Massa Carrara, Carrara, Italy. ppacetti@hotmail.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Pacetti
authors.affiliation: Oncological Department, Azienda USL1 di Massa Carrara, Carrara, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Paganini
authors.affiliation: Oncological Department, Azienda USL1 di Massa Carrara, Carrara, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Orlandi
authors.affiliation: Oncological Department, Azienda USL1 di Massa Carrara, Carrara, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mambrini
authors.affiliation: Oncological Department, Azienda USL1 di Massa Carrara, Carrara, Italy.
authors.forename: M Cristina
authors.initials: MC
authors.lastname: Pennucci
authors.affiliation: Oncological Department, Azienda USL1 di Massa Carrara, Carrara, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Del Freo
authors.affiliation: Oncological department, Poma Hospital, Mantova, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cantore
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D013727:Terminal Care / Q000379:methods*
keywords: Cancer patients; Chemotherapy; End of life