Medical Oncology Unit, CHU of Tours, Bretonneau Hospital, 2 Boulevard Tonnellé, 37000, Tours, France.
Support Care Cancer. 2013 Feb;21(2):405-12. doi: 10.1007/s00520-012-1529-1. Epub 2012 Jun 27.
The treatment of patients with advanced cancer is becoming increasingly aggressive near the end of life, whereas poor literature is available. This study analyzes the management of patients with a solid cancer in their last 3 months of life in the Centre Hospitalier Universitaire de Besançon, France.
This retrospective study includes all adult patients with a solid tumor who died in medical oncology or radiotherapy unit in 2005, 2006, and 2007. Group A had received at least one specific anticancer treatment at the end of life, while group B did not.
Of 167 included patients, 139 (83.2 %) received a specific treatment during the last 3 months of life. The reference unit was medical oncology for 76 % and radiotherapy for 24 % patients; overall survival was 18 and 9 months, and median age of metastatic evolution was 59 and 71 in group A and B, respectively. The number of previous lines of chemotherapy was on average 1.96 and 0.39, respectively. In a univariate analysis, differences appear for reference unit, age of death, and number of previous lines of chemotherapy, with a trend for chemosensitivity of the tumor in this small-sized study. No significant difference was found for sex, life-threatening metastases, or performance status.
These preliminary data suggest that when evaluating the utilization of care at the end of life, one needs to take into account factors such as the age of the patient and the chemosensitivity of the tumor.
在生命的末期，治疗晚期癌症患者的方法变得越来越积极，然而相关文献却很少。本研究分析了法国贝桑松大学医疗中心在患者生命的最后 3 个月时对实体瘤患者的管理方法。
本回顾性研究纳入了 2005 年、2006 年和 2007 年所有在肿瘤内科或放疗科死亡的成年实体瘤患者。A 组至少在生命末期接受过一种特定的抗癌治疗，而 B 组没有。
167 例纳入患者中，139 例（83.2%）在生命的最后 3 个月接受了特定治疗。参考科室为肿瘤内科的占 76%，放疗科的占 24%；总生存期分别为 18 个月和 9 个月，A 组和 B 组转移进展的中位年龄分别为 59 岁和 71 岁。化疗前的线数平均分别为 1.96 次和 0.39 次。单因素分析显示，参考科室、死亡年龄和化疗前的线数存在差异，在这项小规模研究中，肿瘤的化疗敏感性呈趋势性。性别、危及生命的转移和功能状态无显著差异。
这些初步数据表明，在评估生命末期护理的利用情况时，需要考虑患者年龄和肿瘤化疗敏感性等因素。
