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Specific anticancer treatments in the last 3 months of life: a French experience

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Abstract

Purpose

The treatment of patients with advanced cancer is becoming increasingly aggressive near the end of life, whereas poor literature is available. This study analyzes the management of patients with a solid cancer in their last 3 months of life in the Centre Hospitalier Universitaire de Besançon, France.

Methods

This retrospective study includes all adult patients with a solid tumor who died in medical oncology or radiotherapy unit in 2005, 2006, and 2007. Group A had received at least one specific anticancer treatment at the end of life, while group B did not.

Results

Of 167 included patients, 139 (83.2 %) received a specific treatment during the last 3 months of life. The reference unit was medical oncology for 76 % and radiotherapy for 24 % patients; overall survival was 18 and 9 months, and median age of metastatic evolution was 59 and 71 in group A and B, respectively. The number of previous lines of chemotherapy was on average 1.96 and 0.39, respectively. In a univariate analysis, differences appear for reference unit, age of death, and number of previous lines of chemotherapy, with a trend for chemosensitivity of the tumor in this small-sized study. No significant difference was found for sex, life-threatening metastases, or performance status.

Conclusion

These preliminary data suggest that when evaluating the utilization of care at the end of life, one needs to take into account factors such as the age of the patient and the chemosensitivity of the tumor.

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References

  1. Earle CC, Landrum MB, Souza JM, Neville BA, Weeks JC, Ayanian JZ (2008) Aggressiveness of cancer care near the end of life: is it a quality-of-care issue? J Clin Oncol 26(23):3860–3866

    Article  PubMed  Google Scholar 

  2. Earle CC, Neville BA, Landrum MB, Ayanian JZ, Block SD, Weeks JC (2004) Trends in the aggressiveness of cancer care near the end of life. J Clin Oncol 22(2):315–321

    Article  PubMed  Google Scholar 

  3. Braga S, Miranda A, Fonseca R, Passos-Coelho JL, Fernandes A, Costa JD et al (2007) The aggressiveness of cancer care in the last three months of life: a retrospective single centre analysis. Psychooncology 16(9):863–868

    Article  PubMed  Google Scholar 

  4. Emanuel EJ, Young-Xu Y, Levinsky NG, Gazelle G, Saynina O, Ash AS (2003) Chemotherapy use among Medicare beneficiaries at the end of life. Ann Intern Med 138(8):639–643

    PubMed  Google Scholar 

  5. Asola R, Huhtala H, Holli K (2006) Intensity of diagnostic and treatment activities during the end of life of patients with advanced breast cancer. Breast Cancer Res Treat 100(1):77–82

    Article  PubMed  CAS  Google Scholar 

  6. Murillo JR Jr, Koeller J (2006) Chemotherapy given near the end of life by community oncologists for advanced non-small cell lung cancer. Oncologist 11(10):1095–1099

    Article  PubMed  Google Scholar 

  7. Barbera L, Paszat L, Qiu F (2008) End-of-life care in lung cancer patients in Ontario: aggressiveness of care in the population and a description of hospital admissions. J Pain Symptom Manag 35(3):267–274

    Article  Google Scholar 

  8. Ramirez AJ, Towlson KE, Leaning MS, Richards MA, Rubens RD (1998) Do patients with advanced breast cancer benefit from chemotherapy? Br J Cancer 78(11):1488–1494

    Article  PubMed  CAS  Google Scholar 

  9. Geels P, Eisenhauer E, Bezjak A, Zee B, Day A (2000) Palliative effect of chemotherapy: objective tumor response is associated with symptom improvement in patients with metastatic breast cancer. J Clin Oncol 18(12):2395–2405

    PubMed  CAS  Google Scholar 

  10. Modi S, Panageas KS, Duck ET, Bach A, Weinstock N, Dougherty J et al (2002) Prospective exploratory analysis of the association between tumor response, quality of life, and expenditures among patients receiving paclitaxel monotherapy for refractory metastatic breast cancer. J Clin Oncol 20(17):3665–3673

    Article  PubMed  CAS  Google Scholar 

  11. Dufresne A, Pivot X, Tournigand C, Facchini T, Altweegg T, Chaigneau L et al (2008) Impact of chemotherapy beyond the first line in patients with metastatic breast cancer. Breast Cancer Res Treat 107(2):275–279

    Article  PubMed  CAS  Google Scholar 

  12. Shin DB, Bang S-M, Park SH, Kang HG, Jue JI, Han SH et al (2008) Correlation of quality of life with tumor response in patients receiving palliative chemotherapy for advanced gastrointestinal tumors. Med Oncol 25(1):81–87

    Article  PubMed  Google Scholar 

  13. Anderson H, Hopwood P, Stephens RJ, Thatcher N, Cottier B, Nicholson M et al (2000) Gemcitabine plus best supportive care (BSC) vs BSC in inoperable non-small cell lung cancer—a randomized trial with quality of life as the primary outcome. UK NSCLC Gemcitabine Group. Non-Small Cell Lung Cancer. Br J Cancer 83(4):447–453

    Article  PubMed  CAS  Google Scholar 

  14. Cullen MH, Billingham LJ, Woodroffe CM, Chetiyawardana AD, Gower NH, Joshi R et al (1999) Mitomycin, ifosfamide, and cisplatin in unresectable non-small-cell lung cancer: effects on survival and quality of life. J Clin Oncol 17(10):3188–3194

    PubMed  CAS  Google Scholar 

  15. Doyle C, Crump M, Pintilie M, Oza AM (2001) Does palliative chemotherapy palliate? Evaluation of expectations, outcomes, and costs in women receiving chemotherapy for advanced ovarian cancer. J Clin Oncol 19(5):1266–1274

    PubMed  CAS  Google Scholar 

  16. Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA et al (2010) Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 363(8):733–742

    Article  PubMed  CAS  Google Scholar 

  17. Cardoso F, Di LA, Lohrisch C, Bernard C, Ferreira F, Piccart MJ (2002) Second and subsequent lines of chemotherapy for metastatic breast cancer: what did we learn in the last two decades? Ann Oncol 13(2):197–207

    Article  PubMed  CAS  Google Scholar 

  18. Näppä U, Lindqvist O, Rasmussen BH, Axelsson B (2011) Palliative chemotherapy during the last month of life. Ann Oncol 22(11):2375–2380

    Article  PubMed  Google Scholar 

  19. Matsuyama R, Reddy S, Smith TJ (2006) Why do patients choose chemotherapy near the end of life? A review of the perspective of those facing death from cancer. J Clin Oncol 24(21):3490–3496

    Article  PubMed  Google Scholar 

  20. Barbot A-C, Mussault P, Ingrand P, Tourani J-M (2008) Assessing 2-month clinical prognosis in hospitalized patients with advanced solid tumors. J Clin Oncol 26(15):2538–2543

    Article  PubMed  Google Scholar 

  21. Glare P, Virik K, Jones M, Hudson M, Eychmuller S, Simes J et al (2003) A systematic review of physicians’ survival predictions in terminally ill cancer patients. BMJ 327(7408):195–198

    Article  PubMed  Google Scholar 

  22. Maltoni M, Nanni O, Pirovano M, Scarpi E, Indelli M, Martini C et al (1999) Successful validation of the palliative prognostic score in terminally ill cancer patients. Italian Multicenter Study Group on Palliative Care. J Pain Symptom Manag 17(4):240–247

    Article  CAS  Google Scholar 

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Conflict of interest

The authors have no financial or nonfinancial conflict of interest.

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Authors and Affiliations

  1. Medical Oncology Unit, CHU of Tours, Bretonneau Hospital, 2 Boulevard Tonnellé, 37000, Tours, France

    Erika Viel

  2. Medical Oncology Unit, CHU of Besancon, Minjoz Hospital, 3 Boulevard Fleming, 25000, Besancon, France

    Loïc Chaigneau, Elsa Kalbacher, Antoine Thiery-Vuillemnin, Cristian Villanueva, Erion Dobi, Elsa Curtit, Hamadi Almotlak & Xavier Pivot

  3. 12 Rue Ernest Nicolas, 25110, Baume-les-Dames, France

    Eleonor Fanton

  4. Palliative Care Unit, CHU of Besancon, Minjoz Hospital, 3 Boulevard Fleming, 25000, Besancon, France

    Régis Aubry

Authors
  1. Erika Viel
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  2. Loïc Chaigneau
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  3. Eleonor Fanton
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  4. Elsa Kalbacher
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  5. Antoine Thiery-Vuillemnin
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  6. Cristian Villanueva
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  7. Erion Dobi
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  8. Elsa Curtit
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  9. Hamadi Almotlak
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  10. Régis Aubry
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  11. Xavier Pivot
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Correspondence to Erika Viel.

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Viel, E., Chaigneau, L., Fanton, E. et al. Specific anticancer treatments in the last 3 months of life: a French experience. Support Care Cancer 21, 405–412 (2013). https://doi.org/10.1007/s00520-012-1529-1

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  • DOI: https://doi.org/10.1007/s00520-012-1529-1

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