Impact of Continuing Chemotherapy Near Death on Survival
Author Information
Author(s): Saito Akiko M, Landrum Mary Beth, Neville Bridget A, Ayanian John Z, Earle Craig C
Primary Institution: National Hospital Organization Nagoya Medical Center, Aichi, Japan
Hypothesis
Does continuing chemotherapy within two weeks of death improve survival in patients with advanced non-small cell lung cancer?
Conclusion
Continuing chemotherapy until very near death does not prolong survival and reduces the likelihood of receiving hospice care.
Supporting Evidence
- Patients receiving chemotherapy near death were less likely to enter hospice care.
- Continuing chemotherapy did not show any additional survival benefit.
- Patients who received no chemotherapy had a median survival of 6 months.
Takeaway
This study found that patients who keep getting chemotherapy close to death don't live longer and often miss out on hospice care.
Methodology
The study analyzed data from 7,879 Medicare patients aged 65 or older with advanced non-small cell lung cancer, comparing survival based on chemotherapy received within 14 days of death.
Potential Biases
Potential inaccuracies in billing data and retrospective nature of the study may introduce bias.
Limitations
The study is limited to patients aged 65 and older and may not be generalizable to younger patients or those in managed care.
Participant Demographics
Patients were predominantly elderly, with a median age of 73, and included a mix of genders and races.
Statistical Information
P-Value
p<0.001
Confidence Interval
95%CI 0.72, 0.92
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website