Cancer Res Treat.  2018 Jul;50(3):720-728. 10.4143/crt.2017.169.

The Effect of Hospice Consultation on Aggressive Treatment of Lung Cancer

• Yoo SH
• Keam B
• Kim M
• Kim TM
• Kim DW
• Heo DS

• KMID: 2417861
• DOI: http://doi.org/10.4143/crt.2017.169

Abstract

PURPOSE
The aims of this study were to investigate trends of aggressive treatment of non-small cell lung cancer (NSCLC) patients at the end-of-life (EOL) during the recent 5 years and examine the relationship between hospice consultation (HC) and aggressive care.
MATERIALS AND METHODS
The medical records of 789 patients with stage IIIB-IV NSCLC at Seoul National University Hospital (SNUH) who received palliative chemotherapy and died from 2010 to 2014 were retrospectively reviewed. Indicators of aggressive treatment were evaluated, and the association of HC with these indicators was analyzed.
RESULTS
During the last 5 years, the frequency of HC increased from 26.7% to 43.6%. The time interval from last chemotherapy to death increased, and the proportion of patients who received palliative chemotherapy, visited an emergency room, were admitted to intensive care unit, during the last month of life, and died in SNUH significantly decreased over time. Referral to HC was significantly associated with lower intensive care unit admission rates, lower out-of-hospital death rates, and less use of the chemotherapy within 1 month prior to death. Overall survival did not differ by HC.
CONCLUSION
The pattern of cancer care nearthe EOL has become less aggressivewhen HCwas provided. The positive association of HCwith better EOL care suggests that providing HC at the optimal time might help to avoid futile aggressive treatment.

Keyword

Non-small cell lung carcinoma; Aggressiveness; Hospice care; Terminal care; Palliative care; Drug therapy

MeSH Terms

Carcinoma, Non-Small-Cell Lung
Drug Therapy
Emergency Service, Hospital
Hospice Care
Hospices*
Humans
Intensive Care Units
Lung Neoplasms*
Lung*
Medical Records
Mortality
Palliative Care
Referral and Consultation
Retrospective Studies
Seoul
Terminal Care

Figure

• 

  Fig. 1. Overall survival by hospice consultation in 789 patients with non-small cell lung cancer.

Reference

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