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End-of-life intravenous chemotherapy administration patterns in the treatment of Queensland lung and pancreas cancer patients: A 10 year retrospective analysis.
Internal Medicine Journal 2020 October 19
BACKGROUND: End-of-life (EOL) chemotherapy administration rates for solid tumours are 12-20% and is associated with a reduced quality of life, increased hospitalisation, and incidence of death within an acute care facility. We sought to determine the rate of EOL chemotherapy in government and private hospitals and determine the impact on hospitalisations and location of death in lung and pancreatic cancer patients.
METHODS: Data was obtained from the Queensland Oncology Repository between 2005-2014. Lung (n=16,501) and pancreatic cancer (n=4,144) deaths were analysed. EOL chemotherapy was determined to be within 30 days of death. Demographics, location of treatment and death are reported.
RESULTS: Chemotherapy was administered to 6,518 (40%) lung cancer and 1,694 (41%) pancreatic cancer patients. 1,474 (9%) and 477 (12%) patients respectively received EOL chemotherapy. EOL chemotherapy was more common in males and those with distant metastatic disease, whilst less likely in the elderly and those with a lower socioeconomic status. EOL chemotherapy was more prevalent in large hospitals and was more common in private compared to government hospitals for pancreatic cancer (30v26%, p<0.001) whilst it was similar for lung cancer (24v22%, p=0.115). Death after EOL chemotherapy compared to all cancer deaths was more common in an acute care facility (lung cancer: 60 v 37%, p<0.001; pancreas cancer: 53 v 36%, p<0.001).
CONCLUSIONS: EOL chemotherapy rates were similar to Australian yet marginally lower than international rates, with variation dependent on the size and type of facility and increased the rate of deaths within an acute care facility. This article is protected by copyright. All rights reserved.
METHODS: Data was obtained from the Queensland Oncology Repository between 2005-2014. Lung (n=16,501) and pancreatic cancer (n=4,144) deaths were analysed. EOL chemotherapy was determined to be within 30 days of death. Demographics, location of treatment and death are reported.
RESULTS: Chemotherapy was administered to 6,518 (40%) lung cancer and 1,694 (41%) pancreatic cancer patients. 1,474 (9%) and 477 (12%) patients respectively received EOL chemotherapy. EOL chemotherapy was more common in males and those with distant metastatic disease, whilst less likely in the elderly and those with a lower socioeconomic status. EOL chemotherapy was more prevalent in large hospitals and was more common in private compared to government hospitals for pancreatic cancer (30v26%, p<0.001) whilst it was similar for lung cancer (24v22%, p=0.115). Death after EOL chemotherapy compared to all cancer deaths was more common in an acute care facility (lung cancer: 60 v 37%, p<0.001; pancreas cancer: 53 v 36%, p<0.001).
CONCLUSIONS: EOL chemotherapy rates were similar to Australian yet marginally lower than international rates, with variation dependent on the size and type of facility and increased the rate of deaths within an acute care facility. This article is protected by copyright. All rights reserved.
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