Outcomes of Terminally Ill Cancer Patients Receiving Palliative Chemotherapy

Many patients with incurable cancers receive chemotherapy within 30 days of their deaths, but whether this practice helps or harms patients is unclear. In this analysis, U.S. investigators examined whether receiving chemotherapy during the last months of life was associated with subsequent intensive care and place of death among 386 terminally ill adults whose cancers were refractory to at least one chemotherapy regimen and who died a median 4 months after study enrollment. More than half the patients were receiving palliative chemotherapy at enrollment.

Patients who received palliative chemotherapy were significantly more likely than those who did not to prefer receiving “life-extending” over “comfort” care (39% vs. 26%); likewise, they were more likely to express a preference for receiving chemotherapy if it might extend life by 1 week (86% vs. 60%). Palliative chemotherapy patients also were significantly more likely to receive cardiopulmonary resuscitation or mechanical ventilation or both during the last week of life (14% vs. 2%), feeding tubes during the last week of life (11% vs. 5%), and late hospice referral (≤1week; 54% vs. 37%); in addition, they were more likely to die in an intensive care unit (11% vs. 2%) and less likely to die at home (47% vs. 66%). However, survival duration did not differ between the groups.