End-of-life chemotherapy is associated with poor survival and aggressive care in patients with small cell lung cancer
Concerns regarding end-of-life (EOL) chemotherapy are being increasingly raised. Tumor chemosensitivity may influence the decision for aggressive chemotherapy near the EOL. Data on EOL chemotherapy in highly chemosensitive tumors, such as small cell lung cancer (SCLC), are scarce.
A total of 143 SCLC decedents were consecutively included. Data about clinical factors and treatment modalities were obtained from the electronic medical records. The relationships among EOL chemotherapy, clinical features, overall survival (OS), and aggressive care were investigated.
About 64% of patients had chemosensitive disease. In total, 30.8 and 16.1% of patients received EOL chemotherapy within the last 1 and 2 months of life, respectively. Younger age was associated with a higher rate of EOL chemotherapy. We determined that EOL chemotherapy was related to inferior OS not only in the entire group, but also in the chemosensitive subgroup. Furthermore, more intensive care was observed among patients who underwent EOL chemotherapy compared with those who did not.
EOL chemotherapy was correlated with shorter survival and more aggressive care in patients with SCLC. More research is needed to develop indications for terminating palliative chemotherapy, to help physicians and patients with their difficult choices.
KeywordsSmall cell lung cancer (SCLC) End-of-life (EOL) chemotherapy Survival Factor Care
This study was supported by grants from National Health and Family Planning Commission of China (201402011), the National Science Foundation for Young Scientists of China (81602031), the Natural Science Foundation of Shandong Province (ZR201702160004), and Shandong Academy of Medical Sciences (2016-08).
Compliance with ethical standards
Conflict of interest
The authors declare no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. A waiver of informed consent was requested, and approval was obtained from the independent Ethics Committees of Shandong Cancer Hospital and Institute, Shandong University.
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