Cargando…

Palliative Systemic Therapy Given near the End of Life for Metastatic Non-Small Cell Lung Cancer

Background: The use of chemotherapy near end of life (EOL) for various cancers is increasing and has been shown to be associated with delayed access to palliative care (PC) and increased aggressiveness in EOL care, without any benefit on survival. Methods: This retrospective study included 90 patien...

Descripción completa

Detalles Bibliográficos
Autores principales: Beaudet, Marc-Étienne, Lacasse, Yves, Labbé, Catherine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947187/
https://www.ncbi.nlm.nih.gov/pubmed/35323312
http://dx.doi.org/10.3390/curroncol29030112
_version_ 1784674379421974528
author Beaudet, Marc-Étienne
Lacasse, Yves
Labbé, Catherine
author_facet Beaudet, Marc-Étienne
Lacasse, Yves
Labbé, Catherine
author_sort Beaudet, Marc-Étienne
collection PubMed
description Background: The use of chemotherapy near end of life (EOL) for various cancers is increasing and has been shown to be associated with delayed access to palliative care (PC) and increased aggressiveness in EOL care, without any benefit on survival. Methods: This retrospective study included 90 patients with metastatic non-small cell lung cancer (NSCLC) who received at least one line of palliative systemic anticancer therapy (SACT) and died between 1 November 2014, and 31 October 2016, at Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ). Our primary objective was to evaluate the proportion of patients with NSCLC receiving SACT within 30 days of death. Secondary outcomes were to determine the mean and median delays between the administration of the last treatment and death, and to evaluate if there were differences in characteristics and outcomes (including overall survival (OS)) between patients treated or not within 30 days of death. Results: In our cohort, 22% of patients received SACT within 30 days of death. For the entire cohort, the mean delay between the last treatment and death was 94 days, and the median was 57 days. There were no statistically significant differences between the two groups in terms of baseline characteristics. Use of SACT near EOL was associated with decreased access to PC, higher rates of in hospital death, decreased use of medical aid in dying (MAiD), and a shorter median OS (4.0 vs. 9.0 months). Conclusions: In this retrospective cohort of patients with metastatic NSCLC, 22% of patients received SACT within 30 days of death, with a negative impact on access to PC, higher rates of in hospital death, decreased use of MAiD and palliative sedation, and a shorter median OS.
format Online
Article
Text
id pubmed-8947187
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-89471872022-03-25 Palliative Systemic Therapy Given near the End of Life for Metastatic Non-Small Cell Lung Cancer Beaudet, Marc-Étienne Lacasse, Yves Labbé, Catherine Curr Oncol Article Background: The use of chemotherapy near end of life (EOL) for various cancers is increasing and has been shown to be associated with delayed access to palliative care (PC) and increased aggressiveness in EOL care, without any benefit on survival. Methods: This retrospective study included 90 patients with metastatic non-small cell lung cancer (NSCLC) who received at least one line of palliative systemic anticancer therapy (SACT) and died between 1 November 2014, and 31 October 2016, at Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ). Our primary objective was to evaluate the proportion of patients with NSCLC receiving SACT within 30 days of death. Secondary outcomes were to determine the mean and median delays between the administration of the last treatment and death, and to evaluate if there were differences in characteristics and outcomes (including overall survival (OS)) between patients treated or not within 30 days of death. Results: In our cohort, 22% of patients received SACT within 30 days of death. For the entire cohort, the mean delay between the last treatment and death was 94 days, and the median was 57 days. There were no statistically significant differences between the two groups in terms of baseline characteristics. Use of SACT near EOL was associated with decreased access to PC, higher rates of in hospital death, decreased use of medical aid in dying (MAiD), and a shorter median OS (4.0 vs. 9.0 months). Conclusions: In this retrospective cohort of patients with metastatic NSCLC, 22% of patients received SACT within 30 days of death, with a negative impact on access to PC, higher rates of in hospital death, decreased use of MAiD and palliative sedation, and a shorter median OS. MDPI 2022-02-23 /pmc/articles/PMC8947187/ /pubmed/35323312 http://dx.doi.org/10.3390/curroncol29030112 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Beaudet, Marc-Étienne
Lacasse, Yves
Labbé, Catherine
Palliative Systemic Therapy Given near the End of Life for Metastatic Non-Small Cell Lung Cancer
title Palliative Systemic Therapy Given near the End of Life for Metastatic Non-Small Cell Lung Cancer
title_full Palliative Systemic Therapy Given near the End of Life for Metastatic Non-Small Cell Lung Cancer
title_fullStr Palliative Systemic Therapy Given near the End of Life for Metastatic Non-Small Cell Lung Cancer
title_full_unstemmed Palliative Systemic Therapy Given near the End of Life for Metastatic Non-Small Cell Lung Cancer
title_short Palliative Systemic Therapy Given near the End of Life for Metastatic Non-Small Cell Lung Cancer
title_sort palliative systemic therapy given near the end of life for metastatic non-small cell lung cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947187/
https://www.ncbi.nlm.nih.gov/pubmed/35323312
http://dx.doi.org/10.3390/curroncol29030112
work_keys_str_mv AT beaudetmarcetienne palliativesystemictherapygivenneartheendoflifeformetastaticnonsmallcelllungcancer
AT lacasseyves palliativesystemictherapygivenneartheendoflifeformetastaticnonsmallcelllungcancer
AT labbecatherine palliativesystemictherapygivenneartheendoflifeformetastaticnonsmallcelllungcancer