Magarotto Roberto, Lunardi Gianluigi, Coati Francesca, Cassandrini Paola, Picece Vincenzo, Ferrighi Silvia, Oliosi Luciana, Venturini Marco
Oncology Department, Ospedale Sacro Cuore-Don Calabria, Negrar (VR), Italy.
Tumori. 2011 Sep-Oct;97(5):573-7. doi: 10.1177/030089161109700506.
When there is little hope of a clinical benefit, too delayed a withdrawal from chemotherapy might be detrimental for a patient's quality of life. We evaluated appropriately timed cessation of chemotherapy in our Oncology Department after integration of a Supportive and Palliative Care Unit.
We carried out a review of deceased patients in our department from January 2006 to December 2009. Activities of the Supportive and Palliative Care Unit started in late 2007. We analyzed the characteristics of patients near the end of life and chemotherapy use within 30 days of death as an aggressiveness of cure index.
During the considered period, 361 hospitalized patients died: 69 in 2006, 77 in 2007, 97 in 2008 and 118 in 2009; 102 never received chemotherapy. Sixty-one of the remaining 259 patients died within 30 days of the last drug administration. The percentage of patients receiving chemotherapy in their last 30 days fell from 19% in 2006 and 20% in 2007, to 16% in 2008 and 14% in 2009.
Supportive and Palliative Care Unit integration decreased chemotherapy use in the last 30 days of life. A careful evaluation of prognostic factors of advanced cancer patients and provision of appropriate supportive and palliative cares can reduce the use of futile anticancer chemotherapy and preserve a patient's qualify of life.
当临床获益希望渺茫时，化疗撤药过迟可能对患者生活质量不利。在整合了支持与姑息治疗单元后，我们对肿瘤科适时停止化疗的情况进行了评估。
我们回顾了2006年1月至2009年12月在本科室死亡的患者。支持与姑息治疗单元的工作于2007年末开始。我们分析了临终患者的特征以及死亡前30天内化疗的使用情况，将其作为治疗积极性指标。
在研究期间，361名住院患者死亡：2006年69例，2007年77例，2008年97例，2009年118例；102例从未接受过化疗。其余259例患者中有61例在最后一次给药后30天内死亡。在最后30天接受化疗的患者比例从2006年的19%和2007年的20%，降至2008年的16%和2009年的14%。
整合支持与姑息治疗单元减少了生命最后30天内的化疗使用。仔细评估晚期癌症患者的预后因素并提供适当的支持与姑息治疗，可以减少无效抗癌化疗的使用，并维护患者的生活质量。
