# Aggressiveness in systemic anticancer therapy at the end of life in an oncology center

## TL;DR

This study examines how aggressively cancer patients are treated with anticancer therapy in their final months at an oncology center.

## Contribution

The study provides empirical data on the frequency of aggressive systemic anticancer therapy near the end of life in a specific oncology center.

## Key findings

- Approximately 27% of patients received systemic anticancer therapy in the last month of life.
- Metastatic disease was the strongest predictor for receiving systemic anticancer therapy near the end of life.

## Abstract

An increasing aggressiveness in cancer treatment at the end of life (EoL) has been reported in several, but not all, countries. This study aimed to see how aggressive cancer treatment is at the EoL in an oncology center.

Retrospective study of patients 18 years or older with a solid cancer diagnosis who died in 2017. The focus was systemic anticancer therapy (SACT), excluding hormonotherapy.

In 2017, 2024 patients with solid tumors died. Of those patients, 1262 (62%) were male, and the median age was 69 (range 19–97) years. The most frequent primary cancer was lung cancer, followed by colorectal and stomach cancers, and 740 (37%) patients had metastatic disease. The median interval between SACT and death was 61 days. Of the patients undergoing SACT, 216 (27%) did it in the last month of life, 174 (22%) between 8 and 30 days from death, and 42 (5%) in the last week. On multivariable analysis, head and neck, colorectal, breast, and melanoma primaries; age group (older than 65 years); and metastatic disease had statistical significance associated with SACT. Of these variables, only metastatic disease is more likely to undergo SACT.

This study confirms the relatively frequent aggressiveness in cancer treatment at the EoL. Taking into consideration previously published data, it can be tentatively concluded that the use of SACT increased in the last month and the last week of life.