Reasons for chemotherapy discontinuation and end-of-life in patients with gastrointestinal cancer: A multicenter prospective AGEO study - 16/01/21
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Highlights |
• | Chemotherapy was discontinued mainly due to an impaired general condition. |
• | Complications (jaundice, occlusion) were the second cause of discontinuation. |
• | 69% of patients received chemotherapy in the last 3 months of life, 26% in the last month. |
• | 35% of patients were not hospitalized since chemotherapy discontinuation. |
• | 44% of patients died at the hospital, 39% in a palliative care unit and 16% at home. |
Summary |
Background |
Previous research on chemotherapy discontinuation has mainly focused on predictive factors and outcomes. Few data are available on the reasons for chemotherapy discontinuation. The main objective was to identify the reasons for chemotherapy discontinuation in patients with gastrointestinal cancer. The secondary objectives were to describe the announcement of chemotherapy discontinuation and the time between chemotherapy discontinuation and death.
Methods |
This prospective multicenter French cohort included patients with advanced gastrointestinal cancer, for whom chemotherapy was discontinued between May 2016 and January 2018.
Results |
One hundred and fourteen patients were analyzed. The first cause of chemotherapy discontinuation was the impairment of general condition (asthenia, cachexia). Complications such as sepsis, jaundice or occlusion, were the second most frequent cause. Progression was observed at chemotherapy discontinuation in two-thirds of cases. The announcement of the chemotherapy discontinuation was made formally in 74% of cases, with a follow-up by a palliative care team initiated in 50% of cases. Sixty-nine percent of the patients received chemotherapy during the last three months of life and 26% during the last month. The median time between chemotherapy discontinuation and death was 65 days (IQR: 36.5-109): 44% of patients died at the hospital, 39% in a palliative care unit and 16% at home.
Conclusion |
Impairment of general condition was the major reason for chemotherapy discontinuation in patients with gastrointestinal cancers. Complications such as jaundice, sepsis or occlusion, were important reasons for discontinuation and could explain our shorter time between chemotherapy discontinuation and death, compared to other oncology sub-specialties.
Le texte complet de cet article est disponible en PDF.Keywords : Death, Gastrointestinal Neoplasms, Palliative Care, Terminal Care
Plan
Vol 45 - N° 1
Article 101431- janvier 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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