Barak Renana, Safadi Esraa, Nikolaevski-Berlin Alla, Soback Noa, Wolf Ido, Waissengrin Barliz
Oncology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Oncologist. 2025 May 8;30(5). doi: 10.1093/oncolo/oyaf066.
Aggressive end-of-life (EOL) care, such as systemic anticancer therapy (SACT) for advanced cancer patients, represents a potential indicator of low-quality care that may deviate from the primary palliative objective of treatment.
A retrospective study analyzed consecutive patients with advanced cancers treated at a tertiary oncology center in Israel from January 2019 to December 2022. Demographic and clinical data were examined, with a focus on intravenous (IV) oncologic treatment administration rates at 30 and 90 days before death.
The study included 1851 patients who received IV oncologic medications and died during 2019-2022. The median age at death was 69 years, with 51.3% (951) being men. Systemic anticancer therapy administration rates were 36% (666 patients) in the last 30 days and 67.6% (1252 patients) in the last 90 days prior to death. Chemotherapy was the most common EOL medication (58%). Higher EOL SACT rates were associated with younger age, better ECOG performance status, shorter disease duration, and specific tumor origins, particularly breast cancer. Conversely, gender, marital status, and ethnicity showed no significant correlation with EOL treatment use.
Our data provide insight into current practice adopted by healthcare professionals regarding EOL treatment administration in Israel. A positive EOL experience is a significant goal in the oncology clinic, yet our findings demonstrate high rates of aggressive EOL care and may highlight the necessity for regulatory and educational changes within the healthcare system.
积极的临终关怀，如对晚期癌症患者进行全身抗癌治疗（SACT），是低质量护理的一个潜在指标，可能偏离治疗的主要姑息治疗目标。
一项回顾性研究分析了2019年1月至2022年12月在以色列一家三级肿瘤中心接受治疗的连续晚期癌症患者。检查了人口统计学和临床数据，重点关注死亡前30天和90天的静脉内（IV）肿瘤治疗给药率。
该研究纳入了1851名在2019 - 2022年期间接受静脉内肿瘤药物治疗并死亡的患者。死亡时的中位年龄为69岁，男性占51.3%（951人）。全身抗癌治疗给药率在死亡前最后30天为36%（666例患者），在死亡前最后90天为67.6%（1252例患者）。化疗是最常见的临终药物（58%）。较高的临终全身抗癌治疗率与年龄较小、ECOG体能状态较好、疾病持续时间较短以及特定的肿瘤起源相关，尤其是乳腺癌。相反，性别、婚姻状况和种族与临终治疗的使用没有显著相关性。
我们的数据提供了对以色列医疗保健专业人员在临终治疗管理方面当前做法的见解。积极的临终体验是肿瘤诊所的一个重要目标，但我们的研究结果表明积极的临终关怀率很高，可能凸显了医疗保健系统内监管和教育变革的必要性。
