To investigate the treatments of patients with cancer in their last 6 months of life in intensive care unit (ICU) and Cancer Center.
Method:
A prospective study was conducted on patients with cancer who died between January 2010 and July 2013 in the ICU and the Cancer Center (55 and 161 cases, respectively) of Tongji Hospital, Wuhan, China. The differences were compared by Chi-square test or Fisher test.
Results:
The differences in the treatments of patients with cancer between 2 groups were statistically significant. The proportion of patients with cancer who accepted blood transfusion (except albumin) was significantly higher in the ICU than in the Cancer Center.
Conclusion:
Patients with cancer in the ICU were more likely to receive active treatments and less palliative and hospice care at the end of life than patients in the Cancer Center.
EarleCCNevilleBALandrumMB. Trends in the aggressiveness of cancer care near the end of life. J Clin Oncol. 2004;22(2):315–321.
2.
MatsuyamaRReddySSmithTJ. Why do patients choose chemotherapy near the end of life? A review of the perspectives of those facing death from cancer. J Clin Oncol. 2006;24(21):3490–3496.
3.
BarnatoAEHerndonMBAnthonyDL. Are regional variations in end-of-life intensity explained by patient preferences? A study of the US Medicare population. Med Care. 2007;45(5):386–393.
4.
WallaceSKMartinCGShawAD. Influence of an advance directive on the initiation of life support technology in critically ill cancer patients. Crit Care Med. 2001;29(12):2294–2298.
5.
LiuLNChenCHLiuTW. Preferences for aggressive end-of-life care and their determinants among Taiwanese terminally ill cancer patients [published online June 9, 2014.]. Cancer Nurs. 2014.
6.
GrunfeldELethbridgeLDewarR. Towards using administrative databases to measure population-based indicators of quality of end-of-life care: testing the methodology. Palliat Med. 2006;20(8):769–777.
7.
SaitoAMLandrumMBNevilleBAAyanianJZEarleCC. The effect on survival of continuing chemotherapy to near death. BMC Palliat Care. 2011;10:14.
8.
WeeksJCCatalanoPJCroninA. Patients’ expectations about effects of chemotherapy for advanced cancer. N Engl J Med. 2012;367(17):1616–1625.
9.
BuitingHMRurupMLWijsbekHvan ZuylenLden HartoghG. Understanding provision of chemotherapy to patients with end stage cancer: qualitative interview study. BMJ Support Palliat Care. 2011;1(1):33–41.
10.
WenKYLinYCChengJF. Insights into Chinese perspectives on do-not-resuscitate (DNR)orders from an examination of DNR order form completeness for cancer patients. Support Care Cancer. 2013;21(9):2593–2598.
11.
BrueraESweeneyCCalderKPalmerLBenisch-TolleyS. Patient preferences versus physician perceptions of treatment decisions in cancer care. J Clin Oncol. 2001;19(11):2883–2885.
12.
ZdenkowskiNCavenaghJKuYCBisqueraABonaventuraA. Administration of chemotherapy with palliative intent in the last 30 days of life: the balance between palliation and chemotherapy. Intern Med J. 2013;43(11):1191–1198.
13.
TangSTWuSCHungYNChenJSHuangEWLiuTW. Determinants of aggressive end-of-life care for Taiwanese cancer decedents, 2001 to 2006. J Clin Oncol. 2009;27(27):4613–4618.
14.
KypriotakisGFrancisLEO’TooleEToweTPRoseJH. Preferences for aggressive care in underserved populations with advanced-stage lung cancer: looking beyond race and resuscitation. Support Care Cancer. 2014;22(5):1251–1259.
15.
TangSTHuangEWLiuTWWangHMRauKMChenJS. Aggressive end-of-life care significantly influenced propensity for hospice enrollment within the last three days of life for Taiwanese cancer decedents. J Pain Symptom Manage. 2011;41(1):68–78.
16.
TooleMLutzSJohnstonePAS. Radiation oncology quality: aggressiveness of cancer care near the end of life. J Am Coll Radiol. 2012;9(3):199–202.
17.
GrippSMjartanSBoelkeEWillersR. Palliative radiotherapy tailored to life expectancy in end-stage cancer patients. Cancer. 2010;116(13):3251–3256.
18.
AlcornSRSmithTJMcNuttTR. Patterns of palliative radiation near the end of life: A single-institution retrospective analysis. J Clin Oncol. 2013;31(Suppl):abstract 9636.
19.
AlcornSRSmithTJMcNuttTRPatterns of palliative radiation near the end of life: a single-institution retrospective analysis. In: 2013 ASCO; May 31-June 4, 2013; McCormick Place, Chicago, IL. General Poster Session (Board #39H) 9636; 2013.
20.
HuiDKaruturiMSTancoKC. Targeted agent use in cancer patients at the end of life. J Pain Symptom Manage. 2013;46(1):1–8.
21.
SohTIYuenYCTeoCLimSWChanNWongAS. Targeted therapy at the end of life in advanced cancer patients. J Palliat Med. 2012;15(9):991–997.
22.
FearonKCFalconerJSSlaterC. Albumin synthesis rates are not decreased in hypoalbuminemic cachectic cancer patients with an ongoing acute-phase protein response. Ann Surg. 1998, 227(2):249–254.
23.
PeppercornJMSmithTJHelftPR. American society of clinical oncology statement: toward individualized care for patients with advanced cancer. J Clin Oncol. 2011;29(6):755–760.
24.
BurkeTWDeJesusYAChengLPattern of chemotherapy use at end-of-life (EOL) in patients with solid tumors(ST). In: 2013 ASCO; May 31-June 4, 2013; McCormick Place, Chicago, IL. General Poster Session (Board #25C) 9539; 2013.
25.
BarberaLPaszatLChartierC. Indicators of poor quality end-of-life cancer care in Ontario. J Palliat Care. 2006;22(1):12–17.
26.
BükkiJScherbelJStielSKleinCMeidenbauerNOstgatheC. Palliative care needs, symptoms, and treatment intensity along the disease trajectory in medical oncology outpatients: a retrospective chart review. Support Care Cancer. 2013;21(6):1743–1750.
27.
MorrisonRSDietrichJLadwigS. Palliative care consultation teams cut hospital costs for medicaid beneficiaries. Health Aff. 2011;30(3):454–463.
28.
MorishimaTLeeJOtsuboTImanakaY. Association of healthcare expenditures with aggressive versus palliative care for cancer patients at the end of life: a cross-sectional study using claims data in Japan. Int J Qual Health Care. 2014;26(1):79–86.
29.
GonsalvesWITashiTKrishnamurthyJ. Effect of palliative care services on the aggressiveness of end-of-life care in the Veteran’s Affairs cancer population. J Palliat Med. 2011;14(11):1231–1235.
