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- Title
End-of-Life Care in Patients with Metastatic Lung Cancer Harboring Epidermal Growth Factor Receptor Mutations.
- Authors
Bauman, Jessica R.; Piotrowska, Zofia; Muzikansky, Alona; Gallagher, Emily; Scribner, Emily; Temel, Brandon; Sequist, Lecia V.; Heist, Rebecca S.; Temel, Jennifer S.
- Abstract
Background/Objective: Patients with metastatic nonsmall cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations benefit from improved survival and quality of life with EGFR-directed therapy. We sought to explore if these improvements in cancer care impacted the delivery of end-of-life (EOL) care in this population. Design: We retrospectively reviewed medical records of patients cared for at our institution with the diagnosis of metastatic EGFR-mutant NSCLC who died by January 2015. Results: Sixty-one patients were included. The majority of patients were female (68%), white or Asian (97%), and never or minimal smokers (76%). Forty-two out of fifty-eight patients (72%) received chemotherapy within 30 days of death. Forty-one out of sixty-one patients (67%) had a hospital admission within 30 days of death. EOL outcomes were known for 53 patients. Of these, 34 (64%) patients enrolled on hospice. The median length of stay on hospice was 6 days (range 0-206). Thirty-three (62%) patients died at home with hospice services or at an inpatient hospice facility. Eighteen patients (34%) died in the hospital. Conclusion: Patients with metastatic NSCLC harboring EGFR mutations had high rates of chemotherapy use and hospital admissions in the last month of life, and many died in the hospital. Hospital admissions near the EOL and short admissions to hospice are indicators of poor quality EOL care and are likely a result of prolonged chemotherapy administration in this population. Thus, current healthcare delivery models may be insufficient to provide comprehensive EOL care for patients with EGFR mutations.
- Subjects
LUNG tumors; SMOKING; ASIANS; BLACK people; CANCER chemotherapy; CANCER patients; DEATH; EPIDERMAL growth factor; ETHNIC groups; HOSPICE care; LENGTH of stay in hospitals; HOSPITAL admission &; discharge; LUNG cancer; MEDICAL care; MEDICAL quality control; METASTASIS; GENETIC mutation; PATIENTS; RACE; SURVIVAL; TERMINALLY ill; WHITE people; RETROSPECTIVE studies; PATIENT selection; DATA analysis software; DESCRIPTIVE statistics; DIAGNOSIS
- Publication
Journal of Palliative Medicine, 2016, Vol 19, Issue 12, p1316
- ISSN
1096-6218
- Publication type
Article
- DOI
10.1089/jpm.2016.0180