A Review of Chemotherapy and Radiotherapy Near the End of Life in Individuals with Metastatic Non-small Cell Lung Cancer (original) (raw)

Abstract

Objectives Appropriate chemotherapy and radiation near end of life is a moving target; challenged by increasing costs, evolving therapies, new reimbursement models and quality metrics. We review treatment trends and variables impacting the initiation of chemotherapy (CHT) and radiotherapy (XRT) in the final 60, 30 and 14 days of life in metastatic non-small cell lung cancer (NSCLC). Methods The Florida Cancer Data System was studied to complete a retrospective cohort analysis of 48,858 individuals with Stage IV (M1) NSCLC from 1995–2010. We evaluated the initiation of CHT and XRT after diagnosis and associations with patient demographics, insurance and socioeconomic status (SES). Results The use of CHT increased from 35% to 49%, while XRT decreased from 52% to 37% between 1995 and 2010. Initial courses of CHT occurred 8.1%, 5.0%, and 3.6% in the final 60, 30, and 14 days of life, and XRT 13.8%, 7.7%, and 5.2% of the time, respectively. Younger, married, and male patients were more l...

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References (40)

  1. Mariotto AB, Yabroff KR, Shao Y, Feuer EJ, Brown ML. Projections of the cost of cancer care in the United States: 2010-2020. J Natl Cancer Inst. 2011 Jan 19;103(2):117-28.
  2. Glare P, Virik K, Jones M, Hudson M, Eychmuller S, Simes J, et al. A systematic review of physicians' survival predictions in terminally ill cancer patients. BMJ. 2003 Jul 26;327(7408):195-8.
  3. Chow E, Harth T, Hruby G, Finkelstein J, Wu J, Danjoux C. How accurate are physicians' clinical predictions of survival and the available prognostic tools in estimating survival times in terminally ill cancer patients? A systematic review. Clin Oncol R Coll Radiol G B. 2001;13(3):209-18.
  4. Christakis NA, Lamont EB. Extent and determinants of error in physicians' prognoses in terminally ill patients: prospective cohort study. West J Med. 2000 May;172(5):310-3.
  5. Oxenham D, Cornbleet MA. Accuracy of prediction of survival by different professional groups in a hospice. Palliat Med. 1998 Mar;12(2):117-8.
  6. Nappa U, Lindqvist O, Rasmussen BH, Axelsson B. Palliative chemotherapy during the last month of life. Ann Oncol. 2011 Nov 1;22(11):2375-80.
  7. Murillo JR, Koeller J. Chemotherapy Given Near the End of Life by Community Oncologists for Advanced Non-Small Cell Lung Cancer. The Oncologist. 2006 Nov 1;11(10):1095-9.
  8. Emanuel EJ, Young-Xu Y, Levinsky NG, Gazelle G, Saynina O, Ash AS. Chemotherapy Use among Medicare Beneficiaries at the End of Life. Ann Intern Med. 2003 Apr 15;138(8):639-43.
  9. Walasek T, Sas-Korczyńska B, Dąbrowski T, Reinfuss M, Jakubowicz J, Blecharz P, et al. Palliative thoracic radiotherapy for patients with advanced non-small cell lung cancer and poor performance status. Lung Cancer. 2015 Feb 1;87(2):130-5.
  10. Smith TJ, Temin S, Alesi ER, Abernethy AP, Balboni TA, Basch EM, et al. American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. J Clin Oncol Off J Am Soc Clin Oncol. 2012 Mar 10;30(8):880-7.
  11. Stavas MJ, Pagan JD, Varma S, Li B, Kachnic LA. Building a palliative radiation oncology program: From bedside to B.E.D. Pract Radiat Oncol [Internet]. 2016 Sep 13 [cited 2017 Apr 19];0(0). Available from: http://www.practicalradonc. org.proxy.library.vanderbilt.edu/article/S1879- 8500(16)30183-7/fulltext
  12. West L, Cole S, Goodkind D, He W. 65+ in the United States: 2010, United States Census Bureau. [Internet]. [cited 2017 Jun 12]. Available from: https://www.census.gov/content/dam/Census/ library/publications/2014/demo/p23-212.pdf
  13. Certification Levels [Internet]. [cited 2016 Apr 26]. Available from: http://naaccr.org/Certification/ CertificationLevels.aspx
  14. The Florida Cancer Data System Home Page [Internet]. [cited 2016 Apr 26]. Available from: https://fcds.med.miami.edu/inc/welcome.shtml
  15. Earle CC, Neville BA, Landrum MB, Ayanian JZ, Block SD, Weeks JC. Trends in the Aggressiveness of Cancer Care Near the End of Life. J Clin Oncol. 2004 Jan 15;22(2):315-21.
  16. Guadagnolo BA, Liao K-P, Elting L, Giordano S, Buchholz TA, Shih Y-CT. Use of Radiation Therapy in the Last 30 Days of Life Among a Large Population-Based Cohort of Elderly Patients in the United States. J Clin Oncol. 2013 Jan 1;31(1):80-7.
  17. Tiwana MS, Barnes M, Kiraly A, Olson RA. Utilization of palliative radiotherapy for bone metastases near end of life in a population-based cohort. BMC Palliat Care. 2016;15:2.
  18. Kapadia NS, Mamet R, Zornosa C, Niland JC, D'Amico TA, Hayman JA. Radiation therapy at the end of life in patients with incurable nonsmall cell lung cancer. Cancer. 2012 Sep 1;118(17):4339-45.
  19. Weeks JC, Catalano PJ, Cronin A, Finkelman MD, Mack JW, Keating NL, et al. Patients' Expectations about Effects of Chemotherapy for Advanced Cancer. N Engl J Med. 2012 Oct 25;367(17):1616- 25.
  20. Chen AB, Cronin A, Weeks JC, Chrischilles EA, Malin J, Hayman JA, et al. Expectations About the Effectiveness of Radiation Therapy Among Patients With Incurable Lung Cancer. J Clin Oncol. 2013 Jul 20;31(21):2730-5.
  21. Lewis JM, DiGiacomo M, Currow DC, Davidson PM. Dying in the margins: understanding palliative care and socioeconomic deprivation in the developed world. J Pain Symptom Manage. 2011 Jul;42(1):105-18.
  22. Yabroff KR, Kim Y. Time costs associated with informal caregiving for cancer survivors. Cancer. 2009 Sep 15;115(18 Suppl):4362-73.
  23. Dionne-Odom JN, Azuero A, Lyons KD, Hull JG, Tosteson T, Li Z, et al. Benefits of Early Versus Delayed Palliative Care to Informal Family Caregivers of Patients With Advanced Cancer: Outcomes From the ENABLE III Randomized Controlled Trial. J Clin Oncol Off J Am Soc Clin Oncol. 2015 May 1;33(13):1446-52.
  24. Barnato AE, Herndon MB, Anthony DL, Gallagher PM, Skinner JS, Bynum JPW, et al. Are Regional Variations in End-of-Life Care Intensity Explained by Patient Preferences? Med Care. 2007 May;45(5):386-93.
  25. Voogt E, Heide A van der, Rietjens JAC, Leeuwen AF van, Visser AP, Rijt CCD van der, et al. Attitudes of Patients With Incurable Cancer Toward Medical Treatment in the Last Phase of Life. J Clin Oncol. 2005 Mar 20;23(9):2012-9.
  26. Finucane TE. Care of Patients Nearing Death: Another View. J Am Geriatr Soc. 2002 Mar 1;50(3):551-3.
  27. Matsuyama R, Reddy S, Smith TJ. Why do patients choose chemotherapy near the end of life? A review of the perspective of those facing death from cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2006 Jul 20;24(21):3490-6.
  28. MedCrave. Geriatric oncology: where age is not measured by years. Int Clin Pathol J [Internet].
  29. Krishnan MS, Epstein-Peterson Z, Chen Y-H, Tseng YD, Wright AA, Temel JS, et al. Predicting Life Expectancy in Patients With Metastatic Cancer Receiving Palliative Radiotherapy: The TEACHH Model. Cancer. 2014 Jan 1;120(1):134-41.
  30. Kelly CM, Shahrokni A, Kelly CM, Shahrokni A. Moving beyond Karnofsky and ECOG Performance Status Assessments with New Technologies, Moving beyond Karnofsky and ECOG Performance Status Assessments with New Technologies. J Oncol J Oncol. 2016 Mar 15;2016, 2016:e6186543.
  31. Wright AA, Katz IT. Letting Go of the Rope - Aggressive Treatment, Hospice Care, and Open Access. N Engl J Med. 2007 Jul 26;357(4):324-7.
  32. Daugherty CK. Examining ethical dilemmas as obstacles to hospice and palliative care for advanced cancer patients. Cancer Invest. 2004;22(1):123-31.
  33. McGorty EK, Bornstein BH. Barriers to physicians' decisions to discuss hospice: insights gained from the United States hospice model. J Eval Clin Pract. 2003 Aug 1;9(3):363-72.
  34. American Academy of Hospice and Palliative Medicine. Choosing Wisely Campaign® [Internet]. 2013. Available from: http://www.choosingwisely. org/clinician-lists/american-academy-hospice- palliative-care-dont-delay-palliative-care/
  35. Blumenthal D, Abrams M, Nuzum R. The Affordable Care Act at 5 Years. N Engl J Med. 2015 Jun 18;372(25):2451-8.
  36. Burwell SM. Setting Value-Based Payment Goals -HHS Efforts to Improve U.S. Health Care. N Engl J Med. 2015 Mar 5;372(10):897-9.
  37. Ginsburg PB. Spending to Save -ACOs and the Medicare Shared Savings Program. N Engl J Med. 2011 Jun 2;364(22):2085-6.
  38. Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010 Aug 19;363(8):733-42.
  39. Wright AA, Zhang B, Ray A, et al. Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA. 2008 Oct 8;300(14):1665-73.
  40. Jagsi R, Abrahamse P, Hawley ST, Graff JJ, Hamilton AS, Katz SJ. Underascertainment of radiotherapy receipt in Surveillance, Epidemiology, and End Results registry data. Cancer. 2012 Jan 15;118(2):333-41.