The aggressiveness of cancer care in the last three months of life: A retrospective single centre analysis
The aggressiveness of cancer care in the last three months of life: A retrospective single centre analysis
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DOI：
10.1002/pon.1140
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发表时间：
2007-09-01
期刊：
影响因子：
3.6
通讯作者：
Moreira, Antonio
中科院分区：
文献类型：
--
作者：
Braga, Sofia;Miranda, Ana;Moreira, Antonio
背景资料。有人担心，晚期癌症患者过度接受化疗，即使这种治疗不太可能缓解症状。本研究的目的是评估一组成年晚期实体瘤患者在生命最后三个月内的化疗使用情况。方法：纳入2003年在本院死亡并接受晚期癌症化疗的成年实体瘤患者。收集患者生命最后3个月的详细化疗和毒性资料。结果：共纳入319例患者。中位年龄61岁。从诊断为转移性疾病到死亡的中位时间为11个月。在生命的最后三个月接受化疗的患者比例为66%(n=211)，最近一个月接受化疗的比例为37%，最后两周接受化疗的患者比例为21%。在生命最后三个月接受化疗的患者中，50%在此期间开始了新的化疗方案，14%在最后一个月开始接受新的化疗方案。年轻患者和乳腺癌、卵巢癌和胰腺癌患者在生命的最后三个月接受化疗的可能性增加。结论：有很大比例的患者在生命的最后三个月接受过化疗，包括在最近30天内开始新的方案。因此，需要进一步的研究来评估这种咄咄逼人的态度是否会在生命结束时更好地缓解症状。版权所有(C)2007 John Wiley&Sons，Ltd.
Background. There is concern that terminally ill cancer patients are over treated with chemotherapy, even when such treatment is unlikely to palliate symptoms. The study objective was to evaluate the use of chemotherapy in the last three months of life in a cohort of adult patients with advanced solid tumours.Methods: All adult patients with solid tumours who died in our hospital in 2003 and received chemotherapy for advanced cancer, were included. Detailed data concerning chemotherapy and toxicity, in the last three months of life, were collected from patients' clinical charts.Results: A total of 319 patients were included. Median age was 61 years. Median time from diagnosis of metastatic disease to death was 11 months. The proportion of patients who received chemotherapy in the last three months of life was 66% (n = 211), in the last month 37% and in the last two weeks 21%. Among patients who received chemotherapy in the last three months of life, 50% started a new chemotherapy regimen in this period and 14% in the last month. There was an increased probability of receiving chemotherapy in the last three months of life in younger patients and in patients with breast, ovarian and pancreatic carcinomas.Conclusion: There was a large proportion of patients who received chemotherapy in the last three months of life, including initiation of a new regimen within the last 30 days. Thus, further study is needed to evaluate if such aggressive attitude results in better palliation of symptoms at the end of life. Copyright (c) 2007 John Wiley & Sons, Ltd.