Gilbar Peter J, McPherson Ian, Aisthorpe Genevieve G, Kondalsamy-Chennakes Srinivas
1 Cancer and Palliative Care Services, Toowoomba Hospital, Toowoomba, Australia.
2 Rural Clinical School, Faculty of Medicine, The University of Queensland, Toowoomba, Australia.
J Oncol Pharm Pract. 2019 Apr;25(3):599-606. doi: 10.1177/1078155217752077. Epub 2018 Jan 3.
Cessation of chemotherapy at an appropriate time is an important component of good quality palliative care. Published studies looking at administration of chemotherapy at the end of life vary widely.
To retrospectively determine the rate of death occurring within 14 and 30 days of chemotherapy and use this to benchmark against other cancer centres as a quality of care measure.
All adult patients who received systemic anticancer therapy for solid tumours and haematological malignancies at an Australian Regional Cancer Centre between 2011 and 2015 were included.
Over a five-year period, 1215 patients received systemic anticancer therapy. Of these, 23 (1.89%) died within 14 days following systemic anticancer therapy and 68 (5.60%) within 30 days. All patients who died had been treated with palliative intent. Mean time to death was 17.7 days. The majority were female (61.8%) and the mean age was 62.3 years. The most common cause of death was disease progression (80.9%). Nearly half died at the Regional Cancer Centre, including 30.9% who lived in rural or remote localities.
The rate of death observed in this study is at the lower end of the range seen in published studies for both the last 14 and 30 days post-systemic anticancer therapy. It is important to routinely collect data to enable benchmarking against other institutions, determine factors potentially associated with higher risks of mortality at the end of life and improve clinical decision making.
在适当的时候停止化疗是优质姑息治疗的重要组成部分。已发表的关于临终时化疗应用的研究差异很大。
回顾性确定化疗后14天和30天内的死亡率，并以此为依据与其他癌症中心进行对比，作为护理质量的衡量标准。
纳入2011年至2015年期间在澳大利亚某地区癌症中心接受实体瘤和血液系统恶性肿瘤全身抗癌治疗的所有成年患者。
在五年期间，1215例患者接受了全身抗癌治疗。其中，23例（1.89%）在全身抗癌治疗后14天内死亡，68例（5.60%）在30天内死亡。所有死亡患者均接受了姑息治疗。平均死亡时间为17.7天。大多数为女性（61.8%），平均年龄为62.3岁。最常见的死亡原因是疾病进展（80.9%）。近一半患者在地区癌症中心死亡，其中30.9%居住在农村或偏远地区。
本研究观察到的死亡率在已发表研究中全身抗癌治疗后最后14天和30天的死亡率范围内处于较低水平。定期收集数据对于与其他机构进行对比、确定临终时可能与较高死亡风险相关的因素以及改善临床决策非常重要。
