Utilization of systemic palliative chemotherapy at the end of life: a local experience

Objective: To evaluate attitude towards using systemic chemotherapy near the end of life for cancer patients. Methods: This retrospective study comprised data of all patients who died with cancer at the Medical Oncology Department of the National Oncology Centre, Muscat, Oman, from January 2009 to December 2011. The records were retrieved from the electronic patient record system of ALSHIFA, Royal Hospital. Demographic data, chemotherapy at end of life, performance status, 'do not resuscitate' status, hospitalisation, and chemotherapy toxicity were analysed. Results: The mean age of the 261 patients in the study was 52.3+-14.52 years. Ninety-two (35%) patients did not receive chemotherapy in the last 3 months of their lives. Chemotherapy administered at end of life was 169 (65%), 126 (48%), and 75 (29%) in last 3 months, one month and 2 weeks of life. Those who received more than 3 lines of chemotherapy were 66 (36%). Conclusions: The end-of-life use of chemotherapy should always be carefully discussed. The patient's right to information should be honoured. The transition from active to best supportive care should be carefully guided. (author)