Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC G1V 4G5, Canada.
Curr Oncol. 2022 Feb 23;29(3):1316-1325. doi: 10.3390/curroncol29030112.
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.
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.
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).
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.
在生命末期（EOL）使用化疗治疗各种癌症的情况正在增加，并且已经证明与姑息治疗（PC）的延迟获得以及 EOL 护理的侵袭性增加有关，而对生存没有任何益处。
这项回顾性研究纳入了 90 名接受至少一线姑息性全身抗癌治疗（SACT）且于 2014 年 11 月 1 日至 2016 年 10 月 31 日期间在魁北克心血管和肺病研究所（IUCPQ）死亡的转移性非小细胞肺癌（NSCLC）患者。我们的主要目的是评估 NSCLC 患者在死亡前 30 天内接受 SACT 的比例。次要结局是确定最后一次治疗与死亡之间的平均和中位延迟时间，并评估在死亡前 30 天内接受治疗与未接受治疗的患者在特征和结局（包括总生存期（OS））方面是否存在差异。
在我们的队列中，22%的患者在死亡前 30 天内接受了 SACT。对于整个队列，最后一次治疗与死亡之间的平均延迟时间为 94 天，中位数为 57 天。两组在基线特征方面没有统计学上的显著差异。EOL 时使用 SACT 与 PC 获得的减少、更高的院内死亡率、MAiD 的使用减少以及中位 OS 缩短（4.0 与 9.0 个月）相关。
在这项转移性 NSCLC 患者的回顾性队列研究中，22%的患者在死亡前 30 天内接受了 SACT，这对 PC 的获得、更高的院内死亡率、MAiD 的使用减少和姑息性镇静的减少以及中位 OS 缩短产生了负面影响。
