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Experiences with Prescribing Large Quantities of Systemic Anticancer Therapy Near Death.
Baena-Cañada, José M; Campini Bermejo, Alicia; Gámez Casado, Salvador; Rodríguez Pérez, Lourdes; Quílez Cutillas, Alicia; Calvete Candenas, Julio; Martínez Bautista, María J; Benítez Rodríguez, Encarnación.
Afiliação
  • Baena-Cañada JM; Medical Oncology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain.
  • Campini Bermejo A; Medical Oncology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain.
  • Gámez Casado S; Medical Oncology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain.
  • Rodríguez Pérez L; Medical Oncology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain.
  • Quílez Cutillas A; Medical Oncology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain.
  • Calvete Candenas J; Medical Oncology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain.
  • Martínez Bautista MJ; Pharmacy Unit, Hospital Universitario Puerta del Mar, Cádiz, Spain.
  • Benítez Rodríguez E; Provincial Cancer Register, Regional Health Authority, Cádiz, Spain.
J Palliat Med ; 22(12): 1515-1521, 2019 12.
Article em En | MEDLINE | ID: mdl-31184989
Background: The most important decision after diagnosing terminal cancer is whether to provide active therapy or withhold treatment. Objective: To analyze the aggressiveness of care by evaluating systemic anticancer therapy (SACT) given near to death, describing this care and identifying factors that determine its use. Design: This involves retrospective observational cohorts study. Setting/Subjects: This involves patients with metastatic tumors who died at a University Hospital in Spain between 2015 and 2016. Measurements: Data obtained from prescribing oncologists and patients' clinical records, type of cancer, and information on treatment. The dependent variable used was the interval between the date of the last dose and date of death. Results: Ninety-four (32.60%) of 288 patients received SACT in the last month of life. This cohort had a higher frequency of lung cancer (OR: 1.58; CI 95%: 1.14-2.18), received more care from oncologist 2 (OR: 1.50; CI 95%: 1.08-2.08), had fewer last-line treatment cycles (OR: 1.28; CI 95%: 1.13-1.45), a lower subjective response (OR: 3.13; CI 95%: 1.34-7.29), less clinical benefit (OR: 2.38; CI 95%: 1.04-5.55), more visits to the Emergency Department (OR: 1.59; CI 95%: 1.06-2.38), and less care from the Palliative Care Unit (OR: 4.55; CI 95%: 2.69-7.70). In multivariate analysis, the predictors of having received SACT close to death remained: receiving fewer cycles of treatment (OR: 1.28; CI 95%: 1.12-1.47) and less palliative care (OR: 4.54; CI 95%: 2.56-7.69). Conclusions: A third of cancer patients received SACT in the last month of life with less efficacy and poorer quality of care than patients not receiving it.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cuidados Paliativos / Assistência Terminal / Neoplasias / Antineoplásicos Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cuidados Paliativos / Assistência Terminal / Neoplasias / Antineoplásicos Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Ano de publicação: 2019 Tipo de documento: Article