Palliative Chemo for Terminal Cancer Tied to Death in ICU

Share this content:
Palliative Chemo for Terminal Cancer Tied to Death in ICU
Palliative Chemo for Terminal Cancer Tied to Death in ICU

(HealthDay News) — Terminally ill patients with cancer who receive chemotherapy at the end of life are at increased risk of dying in an intensive care unit (ICU) and receiving cardiopulmonary resuscitation (CPR) and/or mechanical ventilation, according to research published March 4 in BMJ.

Alexi A. Wright, MD, of Harvard Medical School in Boston, and colleagues conducted a secondary analysis of data from a prospective, longitudinal study of 386 patients with advanced cancer. The researchers examined the associations between palliative chemotherapy, end-of-life care, and place of death.

The researchers found that 56% of terminally ill cancer patients were receiving palliative chemotherapy at the time of enrollment.

RELATED: Hospice and the Oncology Patient: Why So Much Confusion?

Patients receiving chemotherapy had higher rates of CPR, mechanical ventilation, or both, in the last week of life (14% vs 2%; adjusted risk difference, 10.5%; 95% confidence interval [CI], 5.0% to 15.5%) and late hospice referrals (54% vs 37%; adjusted risk difference, 13.6%; 95% CI, 3.6% to 23.6%), but no difference in survival (hazard ratio, 1.11; 95%, 0.90 to 1.38).

Patients who received palliative chemotherapy were more likely to die in an ICU (11% vs 2%; adjusted risk difference, 6.1%; 95% CI, 1.1% to 11.1%) and less likely to die at home (47% vs 66%; adjusted risk difference, −10.8%; 95% CI, −1.0% to −20.6%).

"Future work should explore how a decision to start chemotherapy, even many months before death, comes to be associated with how and where someone dies," Michael W. Rabow, MD, of the University of California, San Francisco, Helen Diller Comprehensive Cancer Center, wrote in an accompanying editorial.

References

  1. Wright AA, Zhang B, Keating NL, et al. Associations between palliative chemotherapy and adult cancer patients' end of life care and place of death: prospective cohort study. BMJ. 2014; doi:10.1136/bmj.g1219.
  2. Rabow MW. Chemotherapy near the end of life. BMJ. 2014; doi:10.1136/bmj.g1529.

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Sign Up for Free e-newsletters



Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs