| Title |
Chemotherapy Use, Performance Status, and Quality of Life at the End of Life
|
|---|---|
| Published in |
JAMA Oncology, September 2015
|
| DOI | 10.1001/jamaoncol.2015.2378 |
| Pubmed ID | |
| Authors |
Holly G. Prigerson, Yuhua Bao, Manish A. Shah, M. Elizabeth Paulk, Thomas W. LeBlanc, Bryan J. Schneider, Melissa M. Garrido, M. Carrington Reid, David A. Berlin, Kerin B. Adelson, Alfred I. Neugut, Paul K. Maciejewski |
| Abstract |
Although many patients with end-stage cancer are offered chemotherapy to improve quality of life (QOL), the association between chemotherapy and QOL amid progressive metastatic disease has not been well-studied. American Society for Clinical Oncology guidelines recommend palliative chemotherapy only for solid tumor patients with good performance status. To evaluate the association between chemotherapy use and QOL near death (QOD) as a function of patients' performance status. A multi-institutional, longitudinal cohort study of patients with end-stage cancer recruited between September 2002 and February 2008. Chemotherapy use (n = 158 [50.6%]) and Eastern Cooperative Oncology Group (ECOG) performance status were assessed at baseline (median = 3.8 months before death) and patients with progressive metastatic cancer (N = 312) following at least 1 chemotherapy regimen were followed prospectively until death at 6 outpatient oncology clinics in the United States. Patient QOD was determined using validated caregiver ratings of patients' physical and mental distress in their final week. Chemotherapy use was not associated with patient survival controlling for clinical setting and patients' performance status. Among patients with good (ECOG score = 1) baseline performance status, chemotherapy use compared with nonuse was associated with worse QOD (odds ratio [OR], 0.35; 95% CI, 0.17-0.75; P = .01). Baseline chemotherapy use was not associated with QOD among patients with moderate (ECOG score = 2) baseline performance status (OR, 1.06; 95% CI, 0.51-2.21; P = .87) or poor (ECOG score = 3) baseline performance status (OR, 1.34; 95% CI, 0.46-3.89; P = .59). Although palliative chemotherapy is used to improve QOL for patients with end-stage cancer, its use did not improve QOD for patients with moderate or poor performance status and worsened QOD for patients with good performance status. The QOD in patients with end-stage cancer is not improved, and can be harmed, by chemotherapy use near death, even in patients with good performance status. |
X Demographics
The data shown below were collected from the profiles of 533 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 132 | 25% |
| Spain | 34 | 6% |
| United Kingdom | 33 | 6% |
| Netherlands | 25 | 5% |
| Canada | 15 | 3% |
| Japan | 15 | 3% |
| Australia | 11 | 2% |
| France | 9 | 2% |
| Italy | 6 | 1% |
| Other | 42 | 8% |
| Unknown | 211 | 40% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 338 | 63% |
| Practitioners (doctors, other healthcare professionals) | 110 | 21% |
| Scientists | 77 | 14% |
| Science communicators (journalists, bloggers, editors) | 8 | 2% |
Mendeley readers
The data shown below were compiled from readership statistics for 455 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | <1% |
| United Kingdom | 2 | <1% |
| Brazil | 2 | <1% |
| Spain | 2 | <1% |
| Japan | 2 | <1% |
| Denmark | 1 | <1% |
| France | 1 | <1% |
| Netherlands | 1 | <1% |
| Canada | 1 | <1% |
| Other | 0 | 0% |
| Unknown | 440 | 97% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 63 | 14% |
| Student > Master | 51 | 11% |
| Other | 47 | 10% |
| Student > Bachelor | 47 | 10% |
| Student > Ph. D. Student | 47 | 10% |
| Other | 83 | 18% |
| Unknown | 117 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 177 | 39% |
| Nursing and Health Professions | 46 | 10% |
| Biochemistry, Genetics and Molecular Biology | 17 | 4% |
| Pharmacology, Toxicology and Pharmaceutical Science | 13 | 3% |
| Agricultural and Biological Sciences | 10 | 2% |
| Other | 48 | 11% |
| Unknown | 144 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 670. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 April 2024.
All research outputs
#32,427
of 25,784,004 outputs
Outputs from JAMA Oncology
#53
of 3,364 outputs
Outputs of similar age
#284
of 277,664 outputs
Outputs of similar age from JAMA Oncology
#2
of 96 outputs
Altmetric has tracked 25,784,004 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,364 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 84.1. This one has done particularly well, scoring higher than 98% of its peers.
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We're also able to compare this research output to 96 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 97% of its contemporaries.