2024/05/08 by Johnny Singh, Andreas Stensvold, Martin Turzer +2 · 5 citations
Economics, Econometrics and Finance · Medicine · #Cohort #Economic and Financial Impacts of Cancer #Internal medicine #Management of metastatic bone disease #Medicine #Oncology #Palliative Care and End-of-Life Issues #Retrospective cohort study
paper · pdf · doi:10.2340/1651-226x.2024.22139
published in Acta Oncologica 63, 313-321 (Taylor & Francis)
crossref issued 2024/05/08 · crossref published 2024/05/08 · crossref published-online 2024/05/08 · openalex publication_date 2024/05/08 · crossref created 2024/05/08 · crossref deposited 2025/08/28 · openalex created_date 2025/10/10 · crossref indexed 2026/08/05 · openalex updated_date 2026/08/05
BACKGROUND: A significant proportion of patients with incurable cancer receive systemic anticancer therapy (SACT) within their last 30 days of life (DOL). The treatment has questionable benefit, nevertheless is considered a quality indicator of end-of-life (EOL) care. This retrospective cohort study aims to investigate the rates and potential predictors of SACT and factors associated with SACT within the last 30 DOL. The study also evaluates the scope of Eastern Cooperative Oncology Group (ECOG) performance status and the modified Glasgow prognostic score (mGPS) as decision-making tools for oncologists. PATIENTS AND MATERIAL: This review of medical records included 383 patients with non-curable cancer who died between July 2018 and December 2019. Descriptive statistics with Chi-squared tests and regression analysis were used to identify factors associated with SACT within the last 30 DOL. RESULTS: Fifty-seven (15%) patients received SACT within the last 30 DOL. SACT within 30 last DOL was associated with shorter time from diagnosis until death (median 234 days vs. 482, p = 0.008) and ECOG score < 3 30 days prior to death (p = 0.001). Patients receiving SACT during the last 30 DOL were more likely to be hospitalised and die in hospital. ECOG and mGPS score were stated at start last line of treatment only in 139 (51%) and 135 (49%) respectively. INTERPRETATION: Those with short time since diagnosis tended to receive SACT more frequently the last 30 DOL. The use of mGPS as a decision-making tool is modest, and there is lack in documentation of performance status.