A Multicenter Retrospective Review of Systemic Anti-Cancer Treatment and Palliative Care Provided to Solid Tumor Oncology Patients in the 12 Weeks Preceding Death in Ireland. (December 2021)

• Record Type: Journal Article
• Authors: Mallett, Victoria; Linehan, Anna; Burke, Orla; Healy, Laura; Picardo, Sara; Kelly, Catherine M.; McCaffrey, John; Carney, Des; McDermott, Ray; Walshe, Janice; Kelleher, Fergal; Higgins, Stephen; Ryan, Karen; Higgins, Michaela J.
• Is Part Of: American journal of hospice & palliative care. Volume 38:Number 12(2021)
• Page Start: 1404
• Page End: 1408
• Publication Date: 2021-12
• Subjects: end of life care -- systemic treatment -- retrospective study -- chemotherapy -- immunotherapy -- palliative care; Hospice care -- Periodicals; Palliative treatment -- Periodicals; 362.175
• DOI: 10.1177/1049909120985234
• Languages: English
• ISSNs: 1049-9091

Abstract

Background: Systemic anti-cancer treatment (SACT) can improve symptoms and survival in patients with incurable cancer but there may be harmful consequences. Information regarding the use of SACT at the end-of-life and its impact on patients has not been described in Ireland. Aims: The study aimed to quantify and describe the use of SACT at end-of-life. The primary outcome of interest was the number of patients who received treatment in the last 12, 4 and 2 weeks of life. Secondary outcomes included the frequency of admissions and procedures, location of death, and timing of specialist palliative care (SPC) referral. Methods: Retrospective review. Fisher exact testing was used for analyses. Patients were included if they died between January 2015 and July 2017 and received at least 1 dose of treatment for a solid tumor malignancy. Results: Five hundred and eighty two patients were included. Three hundred and thirty eight (58%), 128 (22%) and 36 (6%) received treatment in the last 12, 4 and 2 weeks of life respectively. Patients who received chemotherapy in the last 12 weeks of life were more likely to be admitted to hospital, undergo a procedure, and die in hospital than those who did not (P < 0.001 for all). Median time of SPC referral before death was shorter in those patients who received chemotherapy than those who did not (61 v129 days, p = 0.0001). Conclusion: Patients who received chemotherapy had a higher likelihood of hospital admission, invasive procedure, and in-hospital death. They were less likely to have been referred early to SPC services.