Chemotherapy use in end-of-life digestive cancer patients: a retrospective AGEO observational study

• Published in: Clinics and research in hepatology and gastroenterology 2021-09, Vol.45 (5), p.101709-101709, Article 101709
• Main Authors: Lapeyre-Prost, Alexandra, Perkins, Geraldine, Vallee, Marie, Pozet, Astrid, Tougeron, David, Maillet, Marianne, Locher, Christophe, Dreanic, Johann, Legoux, Jean-Louis, Lièvre, Astrid, Lecaille, Cedric, Sabate, Jean-Marc, Mary, Florence, Bonnetain, Franck, Jaulmes-Bouillot, Hélène, Behal, Florence, Landi, Bruno, Taieb, Julien
• Format: Article
• Language: English
• Subjects: Aged; Aggressiveness of end-of-life care; Antineoplastic Agents - therapeutic use; Cancer; Digestive oncology; End-of-life chemotherapy; Gastrointestinal Neoplasms - drug therapy; Human health and pathology; Humans; Hépatology and Gastroenterology; Life Sciences; Palliative care; Palliative care team; Retrospective Studies; Terminal Care
• ISSN: 2210-7401; 2210-741X
• DOI: 10.1016/j.clinre.2021.101709

•Two-thirds of digestive cancer patients receive chemotherapy within the last 3 months of life.•Young patients and patients with aggressive disease receive more end-of-life chemotherapy.•Palliative care team intervention is associated with less administration of chemotherapy in the last month of life.•Patients who receiving EOL chemotherapy die more often in oncology units than at home or in palliative care unit. The use of chemotherapy (CT) near the end-of-life (EOL) is an important issue in oncology since it could degrade quality of life. CT near EOL is still poorly studied, with no dedicated study in gastrointestinal (GI) cancer patients. To analyze in GI cancer patients the factors associated with the use of CT within 3- and 1-month before patients’ death. All consecutive patients who died from a GI cancer in 10 French tertiary care hospitals during 2014 were included in this retrospective study. Clinical, demographical and biological data were collected and compared between patients receiving or not CT within 3- and 1-month before death. Variables associated with overall survival (OS) was also determined using of univariate and multivariate analyses with a Cox model. Four hundred and thirty-seven patients with a metastatic GI cancer were included in this study. Among them, 293 pts (67.0%) received CT within 3-months before death, and 121 pts (27.7%) received CT within 1-month before death. Patients receiving CT within 3-months before death were significantly younger (median age: 65.5 vs 72.8 years, p