Rautakorpi Liisa K, Seyednasrollah Fatemeh, Mäkelä Johanna M, Hirvonen Outi M, Laitinen Tarja, Elo Laura L, Jyrkkiö Sirkku M
a Department of Oncology and Radiotherapy , Turku University Hospital , Turku , Finland.
b Turku Centre for Biotechnology , University of Turku and Åbo Akademi , Turku , Finland.
Acta Oncol. 2017 Oct;56(10):1272-1276. doi: 10.1080/0284186X.2017.1332424. Epub 2017 May 31.
Recent trends in the end-of-life (EOL) cancer care have suggested that the levels of treatment are becoming more aggressive. The aim of this single-center study was to evaluate the time from the last intravenous (IV) chemotherapy treatment to death and identify factors correlating with treatment closer to death.
The study included all patients diagnosed with cancer at Turku University Central Hospital between the years 2005 and 2013 (N = 38,982) who received IV chemotherapy during the last year of life (N = 3285). The cohort of patients and their respective clinical information were identified from electronic medical records. Statistical analysis was performed to assess and compare the treatment strategies, taking into account the patient's age, the year they were treated, and the type of cancer they were diagnosed with.
A total of 11,250 cancer patients died during the observation time and one-third (N = 3285, 29.2%) of them had received IV chemotherapy during the last year of life. The time from the last IV chemotherapy regimen to death remained consistent across the follow-up time. During the last month of life, every third patient under the age of 50 years and only one-tenth of patients over the age of 80 years received IV chemotherapy. Hematological malignancies and lymphomas were treated closer to death when compared to other diagnostic groups.
During the period of 9 years, the pattern of EOL IV chemotherapy treatment remained stable. Every third patient died at tertiary care. Only 7.2% of patients who received IV chemotherapy during the last year of life were treated 14 days before death, which is in line with international recommendations. However, significant variation in EOL treatment strategies between different diagnosis and age groups were identified.
临终（EOL）癌症护理的近期趋势表明，治疗水平正变得更加积极。这项单中心研究的目的是评估从最后一次静脉内（IV）化疗治疗到死亡的时间，并确定与更接近死亡时治疗相关的因素。
该研究纳入了2005年至2013年间在图尔库大学中心医院被诊断为癌症的所有患者（N = 38,982），这些患者在生命的最后一年接受了静脉化疗（N = 3285）。从电子病历中识别出患者队列及其各自的临床信息。进行统计分析以评估和比较治疗策略，同时考虑患者的年龄、治疗年份以及所诊断的癌症类型。
在观察期内共有11,250名癌症患者死亡，其中三分之一（N = 3285，29.2%）在生命的最后一年接受了静脉化疗。从最后一次静脉化疗方案到死亡的时间在整个随访期间保持一致。在生命的最后一个月，50岁以下的患者中每三人中有一人接受了静脉化疗，而80岁以上的患者中只有十分之一接受了静脉化疗。与其他诊断组相比，血液系统恶性肿瘤和淋巴瘤在更接近死亡时接受治疗。
在9年期间，临终静脉化疗治疗模式保持稳定。每三名患者中有一名在三级护理机构死亡。在生命的最后一年接受静脉化疗的患者中，只有7.2%在死亡前14天接受了治疗，这符合国际建议。然而，不同诊断和年龄组之间的临终治疗策略存在显著差异。
