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Article

Palliative radiotherapy during the last month of life: Predictability for referring physicians and radiation oncologists

  • Authors:
    • Carsten Nieder
    • Kent Angelo
    • Astrid Dalhaug
    • Adam Pawinski
    • Ellinor Haukland
    • Jan Norum
  • View Affiliations / Copyright

    Affiliations: Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø ‑ The Arctic University of Norway, Tromsø, Troms 9037, Norway, Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Nordland 8092, Norway
  • Pages: 3043-3049
    |
    Published online on: September 2, 2015
       https://doi.org/10.3892/ol.2015.3656
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Abstract

Oncologists commonly overestimate the survival time of patients receiving palliative therapy, which may result in the administration of treatments that are too aggressive for patients near the end of their lives. Previous studies have discussed the negative implications of palliative radiotherapy if administered during the last month of life. Models predicting a limited survival time may improve the ability of the oncologists to tailor the treatment according to the needs of each individual patient. In the present study, prognostic factors for survival time, and the use of palliative radiotherapy during the last month of life, were analyzed in 873 patients. Models predicting the likelihood of administering such therapy were examined, and the risk of receiving radiotherapy during the last month of life was observed to be lower in patients with non‑metastatic cancer than in those with metastatic cancer (7 vs. 13%, respectively; P=0.12). On multivariate analysis, 11 factors that significantly influenced the survival time were identified. These findings emphasize the complexity of potential prediction models. The most important risk factor regarding the prediction of extremely short survival times was observed to be an Eastern Cooperative Oncology Group performance status (ECOG PS) of 4, followed by an ECOG PS of 3 (median survival times, 14 and 64 days, respectively). A limited number of patients who received palliative radiotherapy during their last month of life died unexpectedly. Disease‑specific prediction models were developed; however, the small number of events available for analysis limited their immediate clinical impact. Furthermore, these prediction models identified a minority of patients who received radiotherapy during the last month of life. In conclusion, the majority of the palliative radiotherapy courses administered to patients with advanced cancer during their last month of life may be preventable if accurate decision models for the clinic are developed. However, due to the complexity associated with the prediction of survival times in patients receiving palliative radiotherapy, large databases are required to allow accurate models to be established. The present study also discusses the recommendations of the Department of Oncology and Palliative Medicine of Nordland Hospital (Bodø, Nordland, Norway) with regard to the use of palliative radiotherapy during the last month of life of patients with terminal cancer.
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Copy and paste a formatted citation
Spandidos Publications style
Nieder C, Angelo K, Dalhaug A, Pawinski A, Haukland E and Norum J: Palliative radiotherapy during the last month of life: Predictability for referring physicians and radiation oncologists. Oncol Lett 10: 3043-3049, 2015.
APA
Nieder, C., Angelo, K., Dalhaug, A., Pawinski, A., Haukland, E., & Norum, J. (2015). Palliative radiotherapy during the last month of life: Predictability for referring physicians and radiation oncologists. Oncology Letters, 10, 3043-3049. https://doi.org/10.3892/ol.2015.3656
MLA
Nieder, C., Angelo, K., Dalhaug, A., Pawinski, A., Haukland, E., Norum, J."Palliative radiotherapy during the last month of life: Predictability for referring physicians and radiation oncologists". Oncology Letters 10.5 (2015): 3043-3049.
Chicago
Nieder, C., Angelo, K., Dalhaug, A., Pawinski, A., Haukland, E., Norum, J."Palliative radiotherapy during the last month of life: Predictability for referring physicians and radiation oncologists". Oncology Letters 10, no. 5 (2015): 3043-3049. https://doi.org/10.3892/ol.2015.3656
Copy and paste a formatted citation
x
Spandidos Publications style
Nieder C, Angelo K, Dalhaug A, Pawinski A, Haukland E and Norum J: Palliative radiotherapy during the last month of life: Predictability for referring physicians and radiation oncologists. Oncol Lett 10: 3043-3049, 2015.
APA
Nieder, C., Angelo, K., Dalhaug, A., Pawinski, A., Haukland, E., & Norum, J. (2015). Palliative radiotherapy during the last month of life: Predictability for referring physicians and radiation oncologists. Oncology Letters, 10, 3043-3049. https://doi.org/10.3892/ol.2015.3656
MLA
Nieder, C., Angelo, K., Dalhaug, A., Pawinski, A., Haukland, E., Norum, J."Palliative radiotherapy during the last month of life: Predictability for referring physicians and radiation oncologists". Oncology Letters 10.5 (2015): 3043-3049.
Chicago
Nieder, C., Angelo, K., Dalhaug, A., Pawinski, A., Haukland, E., Norum, J."Palliative radiotherapy during the last month of life: Predictability for referring physicians and radiation oncologists". Oncology Letters 10, no. 5 (2015): 3043-3049. https://doi.org/10.3892/ol.2015.3656
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