Use of Palliative Chemo- and Radiotherapy at the End of Life in Patients With Cancer: A Retrospective Cohort Study.
BACKGROUND
Administration of chemotherapy and radiotherapy near the end of life is a frequently discussed issue nowadays. We have evaluated the factors associated with the use of chemotherapy and radiotherapy at the end of life among terminally ill patients in China.


METHODS
This study included the data from patients who had died from advanced cancer who underwent palliative chemotherapy and radiotherapy between January 2007 and December 2013 at the Department of Palliative Care of Fudan University, Shanghai Cancer Center. Data were collected from hospital medical records. Univariate and multivariate analyses were conducted to identify the factors independently associated with the use of chemo- and radiotherapy.


RESULTS
Among the 410 patients included (median age, 68 years; range, 18-93; 53% males), 47 (11.5%) underwent palliative chemotherapy and 28 (6.8%) underwent radiotherapy in the last 30 days. Age <65 years (odds ratio [OR]: 1.33, 95% confidence interval [CI]: 1.06-2.88), performance status <3 (OR: 3.95; 95% CI: 1.56-5.07), and cardiopulmonary resuscitation (OR: 4.09, 95% CI: 2.66-5.34) were independently associated with the use of chemotherapy. Performance status <3 (OR: 4.06, 95% CI: 2.17-5.83) and cardiopulmonary resuscitation (OR: 5.28, 95% CI: 3.77-7.21) were independently associated with the use of radiotherapy.


CONCLUSIONS
The findings indicate that younger patients with a lower performance status who do not have complications are more likely to opt for chemo- or radiotherapy. Further, the use of palliative chemo- and radiotherapy should be considered carefully in terminally ill patients with cancer, as they seem to indicate a higher risk of cardiovascular complications requiring resuscitation.
1 Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.|2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Zhe
Z
Zhang
1 Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.|2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Xiao-Li
XL
Gu
1 Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.|2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Meng-Lei
ML
Chen
1 Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.|2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Ming-Hui
MH
Liu
1 Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.|2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Wei-Wei
WW
Zhao
1 Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.|2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Wen-Wu
WW
Cheng
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
cancer; chemotherapy; end of life; palliative; patients; radiotherapy