Trends in receiving chemotherapy for advanced cancer patients at the end of life

Abstract

BACKGROUND: The use of chemotherapy in advanced cancer patients has increased with the development of novel, high-efficacy anticancer therapeutic agents. In the current study, we analyzed the 10-year trends in patients receiving chemotherapy at the end of life.

METHOD: We retrospectively reviewed mortality data for advanced cancer patients who died in 2000, 2005, and 2010 at a single institution. The trends of receiving palliative chemotherapy at the end of life were assessed for each year. In addition, logistic regression analysis was performed to determine the factors associated with receiving chemotherapy.

RESULTS: We analyzed the records of 2,345 patients who died of cancer. Patients with less responsive tumors were less likely to receive chemotherapy than patients with responsive tumors at the time of death. Patients who were ≥ 65 years were less likely to receive chemotherapy compared with patients who were < 65 years at the end of life. However, the proportion of older patients receiving chemotherapy in the last month of life increased in 2010 (44.2%) compared with 2005 (32.7%) and 2000 (25.7%). Compared with the year 2000, the likelihood of receiving chemotherapy during the last 1 month of life increased in 2005 (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.60-2.62) and 2010 (OR, 4.42; 95% CI, 3.51-5.57).

CONCLUSIONS: The proportion of patients receiving chemotherapy at the end of life increased successively from 2000 to 2005 to 2010. Physicians should consider whether to continue chemotherapy at the end of life.