TY - JOUR
T1 - Chemotherapy and Tyrosine Kinase Inhibitors in the last month of life in patients with metastatic lung cancer
T2 - A patient file study in the Netherlands
AU - Mieras, Adinda
AU - Becker-Commissaris, Annemarie
AU - Pasman, H. Roeline W.
AU - Dingemans, Anne Marie M.C.
AU - Kok, Edith V.
AU - Cornelissen, Robin
AU - Jacobs, Wouter
AU - van den Berg, Jan Willem
AU - Welling, Alle
AU - Bogaarts, Brigitte A.H.A.
AU - Pronk, Lemke
AU - Onwuteaka-Philipsen, Bregje D.
N1 - © 2019 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.
PY - 2019
Y1 - 2019
N2 - Objective: Chemotherapy in the last month of life for patients with metastatic lung cancer is often considered as aggressive end-of-life care. Targeted therapy with Tyrosine Kinase Inhibitors (TKIs) is a relatively new treatment of which not much is known yet about use in the last month of life. We examined what percentage of patients received chemotherapy or TKIs in the last month of life in the Netherlands. Methods: Patient files were drawn from 10 hospitals across the Netherlands. Patients had to meet the following eligibility criteria: metastatic lung cancer; died between June 1, 2013 and July 31, 2015. Results: From the included 1,322 patients, 39% received no treatment for metastatic lung cancer, 52% received chemotherapy and 9% received TKIs. A total of 232 patients (18%) received treatment in the last month of life (11% chemotherapy, 7% TKIs). From the patients who received chemotherapy, 145 (21%) received this in the last month of life and 79 (11%) started this treatment in the last month of life. TKIs were given and started more often in the last month of life: from the patients who received TKIs, 87 (72%) received this treatment in the last month of life and 15 (12%) started this treatment in the last month of life. Conclusion: A substantial percentage of patient received and even started chemotherapy or TKIs in the last month of life. For chemotherapy, this might be seen as aggressive care. TKIs are said to have less side effects, do not lead to many hospital visits and due to the rapid response, are considered good palliation. However, it is not known, yet possible that, when patients still receiving treatment until shortly before death, this might influence preparing for death in a negative way.
AB - Objective: Chemotherapy in the last month of life for patients with metastatic lung cancer is often considered as aggressive end-of-life care. Targeted therapy with Tyrosine Kinase Inhibitors (TKIs) is a relatively new treatment of which not much is known yet about use in the last month of life. We examined what percentage of patients received chemotherapy or TKIs in the last month of life in the Netherlands. Methods: Patient files were drawn from 10 hospitals across the Netherlands. Patients had to meet the following eligibility criteria: metastatic lung cancer; died between June 1, 2013 and July 31, 2015. Results: From the included 1,322 patients, 39% received no treatment for metastatic lung cancer, 52% received chemotherapy and 9% received TKIs. A total of 232 patients (18%) received treatment in the last month of life (11% chemotherapy, 7% TKIs). From the patients who received chemotherapy, 145 (21%) received this in the last month of life and 79 (11%) started this treatment in the last month of life. TKIs were given and started more often in the last month of life: from the patients who received TKIs, 87 (72%) received this treatment in the last month of life and 15 (12%) started this treatment in the last month of life. Conclusion: A substantial percentage of patient received and even started chemotherapy or TKIs in the last month of life. For chemotherapy, this might be seen as aggressive care. TKIs are said to have less side effects, do not lead to many hospital visits and due to the rapid response, are considered good palliation. However, it is not known, yet possible that, when patients still receiving treatment until shortly before death, this might influence preparing for death in a negative way.
KW - Tyrosine Kinase Inhibitors
KW - aggressive care
KW - cancer treatment
KW - chemotherapy
KW - end of life
KW - metastatic lung cancer
UR - http://www.scopus.com/inward/record.url?scp=85076893131&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/ecc.13210
DO - https://doi.org/10.1111/ecc.13210
M3 - Article
C2 - 31863609
SN - 0961-5423
JO - European journal of cancer care
JF - European journal of cancer care
M1 - e13210
ER -