Use of chemotherapy at end of life in oncology patients
Use of chemotherapy at end of life in oncology patients
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DOI：
10.1093/annonc/mdp027
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发表时间：
2009-09-01
影响因子：
50.5
通讯作者：
Adams, D.
中科院分区：
文献类型：
--
作者：
Kao, S.;Shafiq, J.;Adams, D.
方法：回顾了2005年4月以来在两个癌症中心接受姑息治疗的死亡肿瘤患者。对患者人口统计学、癌症和化疗变量进行卡方检验，以确定在死亡后2周和4周内开始化疗和继续化疗的相关性。多变量分析进行了显着因素，以确定其独立effect.Results：七百四十七例患者在此期间死亡，中位年龄67岁（范围20-96），女性44%。398例（53%）接受化疗：分别有18%和8%在死亡后4周和2周内接受化疗。多因素分析显示，年龄小（P < 0.01）、肿瘤类型（P < 0.01）和肿瘤化疗敏感性（P < 0.01）是开始化疗的预测因素。治疗医生在死亡前4周内预测化疗（< 0.05），但在生命的最后2周内没有预测化疗的变量。结论：年龄小、肿瘤类型和化疗敏感性是患者接受姑息化疗的重要预测因素。个体临床医生是生命最后4周内继续化疗的唯一预测因素。
Methods: A review of deceased oncology patients treated with palliative intent from April 2005 over 2 years at two cancer centres was carried out. Chi-square tests of patient demographics, cancer and chemotherapy variables were carried out to determine associations with commencing chemotherapy and continuation within 2 and 4 weeks of death. Multivariate analyses were carried out with significant factors to determine their independent effect.Results: Seven hundred and forty-seven patients died during this period; median age 67 years (range 20-96); female 44%. Three hundred and ninety-eight (53%) received chemotherapy: 18% and 8% within 4 and 2 weeks of death, respectively. Younger age (P < 0.01), cancer type (P < 0.01) and chemosensitivity of the tumour (P < 0.01) were predictors for commencing chemotherapy in multivariate analysis. Treating doctor predicted for chemotherapy in the 4 weeks before death (< 0.05), but none of the variables predicted for chemotherapy in the last 2 weeks of life.Conclusions: Younger age, tumour type and chemosensitivity are important predictors of patients receiving palliative chemotherapy. Individual clinician was the only predictor for continuing chemotherapy in the last 4 weeks of life.