 |
Vol.52 No.7 contents | Japanese/English |
 | Full Text of PDF (452K) Article in Japanese |
- Original Article -
Differences in End-of-life Care Continuing Chemotherapy to Near Death Between Lung Cancer Patients and Other Solid Tumor Patients
Kikuo Nakano1, Takashi Yoshida1, Yoshihiro Kitahara1, Masashi Namba1, Shoji Sunada21Department of Respiratory Medicine, 2Department of Palliative Medicine, National Hospital Organization Kure Medical Center, Japan
Objectives. The aim of this study was to describe the differences in end-of-life care, focusing on continuing chemotherapy to near death, between lung cancer patients and patients with other solid tumors. Methods. A retrospective analysis was conducted using data of patients who received at least first-line chemotherapy and died at the same institute where they were treated. A total of 375 patients who died of lung (131), stomach (69), colorectal (36), breast (30), gynecological (17), and lymphohematological (92) cancers in 2007-2009 was assessed. End-of-life care focusing on chemotherapy use, reason for final admission to hospital, and location of death was examined. Results. The percentage of patients receiving chemotherapy within the last month of life was the highest for lymphohematological cancer (67%), followed by lung, breast, stomach, colorectal, and gynecological cancers, in that order. The median number of days between the last dose of chemotherapy and death was shorter for lung cancer (42.0 days) than for colorectal cancer (131.0 days) or gynecological cancer (100.0 days, P<0.006). Respiratory failure as the reason for final admission to hospital was most common for lung cancer, and appetite loss was most common for stomach and colorectal cancers. The prevalence of patients who died in a palliative care unit (PCU) was highest in gynecological cancer (71%), followed by colorectal, stomach, breast, lung, and lymphohematological cancers, in that order. Moreover, among the 100 eligible patients with non-small-cell lung cancer, the patients were categorized into two groups: those who died in general wards, and those who died in the PCU. The median number of days between the last dose of chemotherapy and death was shorter in the general wards than in the PCU (36.0 versus 177.0 days, P<0.001). Conclusions. Lung cancer patients receive the poorest quality of end-of-life-care as compared to other solid tumor patients, and it is necessary to optimize the timing of final chemotherapy administration.
key words: End-of-life care, Palliative chemotherapy, Solid tumors, Non-small-cell lung cancer
Received: June 4, 2012
Accepted: September 19, 2012
JJLC 52 (7): 995-1000, 2012
