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The Effect of Hospice Consultation on Aggressive Treatment of Lung Cancer

Cancer Research and Treatment
2018년 50권 3호 p.720 ~ p.728
유신혜 ( Yoo Shin-Hye ) - Seoul National University Hospital Department of Internal Medicine

김범석 ( Keam Bhum-Suk ) - Seoul National University Hospital Department of Internal Medicine
김미소 ( Kim Mi-So ) - Seoul National University Hospital Department of Internal Medicine
김태민 ( Kim Tae-MIn ) - Seoul National University Hospital Department of Internal Medicine
김동완 ( Kim Dong-Wan ) - Seoul National University Hospital Department of Internal Medicine
허대석 ( Heo Dae-Seog ) - Seoul National University Hospital Department of Internal Medicine

Abstract

Purpose: The aims of this study were to investigate trends of aggressive treatment of non-small cell lung cancer (NSCLC) patients at the end-of-life (EOL) during the recent 5 years and examine the relationship between hospice consultation (HC) and aggressive care.

Materials and Methods: The medical records of 789 patients with stage IIIB-IV NSCLC at Seoul National University Hospital (SNUH) who received palliative chemotherapy and died from 2010 to 2014 were retrospectively reviewed. Indicators of aggressive treatment were evaluated, and the association of HC with these indicators was analyzed.

Results: During the last 5 years, the frequency of HC increased from 26.7% to 43.6%. The time interval from last chemotherapy to death increased, and the proportion of patients who received palliative chemotherapy, visited an emergency room, were admitted to intensive care unit, during the last month of life, and died in SNUH significantly decreased over time. Referral to HC was significantly associated with lower intensive care unit admission rates, lower out-of-hospital death rates, and less use of the chemotherapy within 1 month prior to death. Overall survival did not differ by HC.

Conclusion: The pattern of cancer care nearthe EOL has become less aggressivewhen HCwas provided. The positive association of HCwith better EOL care suggests that providing HC at the optimal time might help to avoid futile aggressive treatment.

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