Chemotherapy in patients with advanced pancreatic cancer: too close to death?
| Autor: | M. Frigeri, H. Neuenschwander, S. De Dosso, O. Castillo-Fernandez, Piercarlo Saletti, K. Feuerlein |
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| Rok vydání: | 2012 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Palliative care medicine.medical_treatment Antineoplastic Agents Inappropriate Prescribing Adenocarcinoma Internal medicine Pancreatic cancer medicine Humans In patient Practice Patterns Physicians' Survival analysis Aged Retrospective Studies Aged 80 and over Chemotherapy business.industry Disease progression Palliative Care Retrospective cohort study Middle Aged medicine.disease Survival Analysis Drug Utilization Pancreatic Neoplasms Multivariate Analysis Disease Progression Female business Switzerland |
| Zdroj: | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 21(1) |
| ISSN: | 1433-7339 |
| Popis: | We evaluated the attitude in using chemotherapy near the end of life in advanced pancreatic adenocarcinoma (PAC). Clinical and laboratory parameters recorded at last chemotherapy administration were analyzed, in order to identify risk factors for imminent death.Retrospective analysis of patients who underwent at least one line of palliative chemotherapy was made. Data concerning chemotherapy (regimens, lines, and date of last administration) were collected. Clinical and laboratory factors recorded at last chemotherapy administration were: performance status, presence of ascites, hemoglobin, white blood cell (WBC), platelets, total bilirubin, albumin, LDH, C-reactive protein (C-rp), and Ca 19.9.We analyzed 231 patients: males/females, 53/47 %; metastatic/locally advanced disease, 80/20 %; and median age, 66 years (range 32-85). All patients died due to disease progression. Median overall survival was 6.1 months (95 % CI 5.1-7.2). At the last chemotherapy delivery, performance status was 0-1 in 37 % and 2 in 63 %. Fifty-nine percent of patients received one chemotherapy line, while 32, 8, and 1 % had second-, third-, and fourth line, respectively. The interval between last chemotherapy administration and death was4 weeks in 24 %, ≥4-12 in 47 %, and12 in 29 %. Median survival from last chemotherapy to death was 7.5 weeks (95 % CI 6.7-8.4). In a univariate analysis, ascites, elevated WBC, bilirubin, LDH, C-rp and Ca 19.9, and reduced albumin were found to predict shorter survival; however, none of them remained significant in a multivariate analysis.A significant proportion of patients with advanced PAC received chemotherapy within the last month of life. The clinical and laboratory parameters recorded at last chemotherapy delivery did not predict shorter survival. |
| Databáze: | OpenAIRE |
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