Use of chemotherapy at the end of life among Taiwanese cancer decedents, 2001-2006
Use of chemotherapy at the end of life among Taiwanese cancer decedents, 2001-2006
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DOI：
10.3109/0284186x.2011.653440
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发表时间：
2012-04-01
期刊：
影响因子：
3.1
通讯作者：
Tang, Siew Tzuh
中科院分区：
文献类型：
--
作者：
Liu, Tsang-Wu;Chang, Wen-Cheng;Tang, Siew Tzuh
导论.新的化疗药物的可用性延长了晚期癌症的治疗时间轴，并增加了接受化疗接近死亡的可能性。在生命末期使用化疗可能对癌症患者没有好处。然而，没有基于人口的研究已经检查了所有年龄和癌症组以及整个国家在生命结束时继续化疗的决定因素。这项基于人群的研究评估了生命最后一个月继续化疗与患者人口统计学、疾病特征、主治医生的专业、医院特征以及医院和地区水平的医疗资源可用性之间的关联。材料和方法。2001-2006年204850名台湾癌症死亡者的回顾性人群队列研究。结果在每个研究年中，生命最后一个月继续化疗的比例分别为17.5%、17.4%、17.3%、19.0%、20.0%和21.0%，自2001年以来一直保持稳定。如果台湾癌症患者是男性[校正比值比（AOR）1.19，95%置信区间（CI）1.13-1.25]，年轻，单身[1.21]，则在生命的最后一个月继续化疗的几率更大。（1.09-1.35）]，合并症水平较低，被诊断为恶性血液病[1.90（1.09-1.35）]和乳腺癌[1.24（1.08-1.43）]，有转移性疾病[1.36（1.27-1.46）]，并且存活
Introduction. The availability of new chemotherapeutic agents has lengthened the treatment timeline for advanced cancers and increases the likelihood of receiving chemotherapy near death. Use of chemotherapy near the end of life may not benefit cancer patients. However, no population-based study has examined the determinants for continuing chemotherapy at the end of life for all ages and cancer groups as well as for a whole country. This population-based study assessed the association between continuation of chemotherapy in the last month of life and patient demographics, disease characteristics, primary physician's specialty, hospital characteristics, and healthcare resource availability at the hospital and regional levels. Materials and methods. Retrospective population-based cohort study using administrative data among 204 850 Taiwanese cancer decedents in 2001-2006. Results. Rates of continued chemotherapy in the last month of life for each study year were 17.5%, 17.4%, 17.3%, 19.0%, 20.0%, and 21.0%, respectively and have remained steady since 2001. Taiwanese cancer patients had greater odds for continuation of chemotherapy in the last month of life if they were male [adjusted odds ratio (AOR) 1.19, 95% confi dence interval (CI) 1.13-1.25], younger, single [1.21 (1.09-1.35)], had lower comorbidity levels, were diagnosed with hematologic malignancies [1.90 (1.09-1.35)] and breast cancer [1.24 (1.08-1.43)], had metastatic disease [1.36 (1.27-1.46)], and survived