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Palliative chemotherapy during the last month of life
Date de l'article :
2012-02-29
Auteurs :
U. Na¨ ppa¨ 1,2,3*, O. Lindqvist3,4,5, B. H. Rasmussen3 & B. Axelsson1,2
Affiliations :
1The Research and Development Unit, O¨stersund Hospital, O¨ stersund; Departments of 2Radiation Sciences; 3Nursing, University of Umea°, Umea°; 4Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institute, Stockholm; 5Research and Development Unit in Palliative Care, Stockholms Sjukhem Foundation, Stockholm, Sweden
Source :
Annals of Oncology 22: 2375–2380, 2011
Abstract :
Background: This study analyses the potential discriminative characteristics for patients with incurable cancer who received palliative chemotherapy during their last month of life. Patients and methods: The study includes all patients with epithelial cancer treated with palliative chemotherapy who died in 2008 in northern Sweden. Demographic parameters and care utilization data were registered. Data were analyzed using nonparametric methods. Results: Of 374 included patients, 87 (23%) received chemotherapy during the last month of life. These patients had a significantly shorter survival time from first palliative treatment to death, were admitted more frequently to hospital, more often lacked a documented decision to cease treatment, and died less frequently at home. Conclusions: The results indicate covariations between palliative chemotherapy treatments in the last month of life and unfavorable patient outcomes. As almost one of four patients with incurable cancer received their last round of palliative chemotherapy <31 days before death, there is a potential for improved routines
Commentaires :
Ceci est un court article qui nous rappelle quand il faut penser arrêter la chimiothérapie.....si on est impliqué plus tôt en soins palliatifs ceci peut aider à amorcer une discussion et limiter les catastrophes de familles qui ne comprennent pas que leur proche est rendu en phase terminale et il y a ainsi un beau temps de rapprochement familiale qui est manqué lorsque rien n'est cessé en temps et même on rencontre des prolongations inattendues lorsque certaines chimiothérapies sont cessé. En clinique externe , j'ai eu quelques patients référés pour trois mois et que j'ai suivi plu d'un an […]