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Supportive Care in Cancer
Published in: Supportive Care in Cancer 4/2016

01-04-2016 | Original Article

Treatment of cancer patients in their last month of life: aimless chemotherapy

Authors: Tarek Assi, Elie El Rassy, Samer Tabchi, Toni Ibrahim, Tania Moussa, Ralph Chebib, Fadi El Karak, Fadi Farhat, Georges Chahine, Fadi Nasr, Marwan Ghosn, Joseph Kattan

Published in: Supportive Care in Cancer | Issue 4/2016

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Abstract

Purpose

The use of chemotherapy in the last month of life (CLML) of cancer patients is considered an aggressive approach to be avoided. We examined the practice of CLML in Lebanese cancer patients, and we investigated patient and tumor characteristics that justify this practice. To our knowledge, this is the first study describing CLML of Middle Eastern patients with advanced cancer.

Methods

We conducted this study at Hotel-Dieu de France University Hospital (HDF), Lebanon. Cases eligible for this study were all individuals diagnosed with cancer who died at HDF between the 1st of January and the 31st of December 2014. Demographic and clinical characteristics of the patients were obtained from the hospital registration records. Data concerning the management plan, primary malignancy and stage, chemo-sensitivity, line, type, and timing of chemotherapy in the last month of life were also obtained.

Results

Among the 130 cancer patients who were enrolled, CLML was administered to a total of 55 patients (42.3 %), of whom 26 patients (50 %) received more than one cytotoxic drug. Oral drug was only given to 9 patients (16.4 %). Interestingly, CLML increased the risk of death in the last month of life (p = 0.02), yet progression of disease constituted the major cause of death in this subgroup (54.6 %). The only variable to have statistical significant correlation with CLML was performance status (p = 0.03). The type of tumor and recent diagnosis of less than 2 months were also correlated to CLML (p = 0.03 and 0.024, respectively).

Conclusion

The high percentage of patients receiving CLML underlines the difficulty of end-of-life discussions in patients from Middle Eastern societies. This is true in the context of a country with little availability of palliative care resources, where health policies should be more focused on incorporating palliative medicine in all medical strategies.
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Metadata
Title
Treatment of cancer patients in their last month of life: aimless chemotherapy
Authors
Tarek Assi
Elie El Rassy
Samer Tabchi
Toni Ibrahim
Tania Moussa
Ralph Chebib
Fadi El Karak
Fadi Farhat
Georges Chahine
Fadi Nasr
Marwan Ghosn
Joseph Kattan
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 4/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-015-2959-3

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