Palliative Radiotherapy Near the End of Life: An Analysis of Factors Influencing the Administration of Radiotherapy in Advanced Tumor Disease
PURPOSEPalliative radiotherapy (PRT) toward the end of life (EOL) in advanced tumor disease is contentious. Although EOL RT can alleviate cancer-related symptoms, relief typically occurs weeks to months after treatment, potentially compromising the quality of life of patients during the final stages...
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| Format: | Article |
| Language: | English |
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American Society of Clinical Oncology
2025-04-01
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| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO-24-00500 |
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| author | Nguyen-Son Le Asli Zeybek Klaus Hackner Cornelia Gallauner Josef Singer Felix Schragel Petra Georg Sandra Gottsauner-Wolf Martin Pecherstorfer Gudrun Kreye |
| author_facet | Nguyen-Son Le Asli Zeybek Klaus Hackner Cornelia Gallauner Josef Singer Felix Schragel Petra Georg Sandra Gottsauner-Wolf Martin Pecherstorfer Gudrun Kreye |
| author_sort | Nguyen-Son Le |
| collection | DOAJ |
| description | PURPOSEPalliative radiotherapy (PRT) toward the end of life (EOL) in advanced tumor disease is contentious. Although EOL RT can alleviate cancer-related symptoms, relief typically occurs weeks to months after treatment, potentially compromising the quality of life of patients during the final stages. This study aims to assess factors influencing the decision-making process regarding EOL RT.MATERIALS AND METHODSThis retrospective study of a real-world cohort included 684 consecutive patients with a diagnosis of a solid tumor who died between 2017 and 2021. In these patients, factors potentially influencing the administration of EOL RT were analyzed.RESULTSOf the 684 patients, 164 received PRT, with 60 (36.6%) receiving EOL RT within the last 30 days of life. The median time from the last RT session to death was 55 days. Significant factors influencing EOL RT administration were age ≤65 years (odds ratio [OR], 1.75 [95% CI, 1.02 to 3.01]), Union for International Cancer Control stage IV (OR, 2.77 [95% CI, 1.41 to 5.46]), lung cancer (OR, 2.16 [95% CI, 1.00 to 4.68]), palliative care referral (OR, 1.80 [95% CI, 0.98 to 3.30]), systemic anticancer treatment ≤30 days before death (OR, 1.87 [95% CI, 1.05 to 3.33]), and Eastern Cooperative Oncology Group performance status ≥2 (OR, 3.73 [95% CI, 1.88 to 7.40]). Furthermore, RT near the EOL was more likely administered at multiple sites (OR, 2.08 [95% CI, 1.00 to 4.29]) and with ≤5 fractions (OR, 2.37 [95% CI, 1.23 to 4.57]), while being associated with lower response rates (OR, 0.43 [95% CI, 0.21 to 0.86]) and increased therapy discontinuation (OR, 4.40 [95% CI, 1.45 to 13.37]).CONCLUSIONThese findings highlight varying RT patterns influenced by specific factors, demonstrating the complexity of EOL treatment decisions in advanced cancer care. Identifying key factors for personalized, patient-centered EOL RT decisions warrants further investigation. |
| format | Article |
| id | doaj-art-e91bab9cb54b4152a033a6ed416284c4 |
| institution | DOAJ |
| issn | 2687-8941 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj-art-e91bab9cb54b4152a033a6ed416284c42025-08-20T03:18:13ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412025-04-011110.1200/GO-24-00500Palliative Radiotherapy Near the End of Life: An Analysis of Factors Influencing the Administration of Radiotherapy in Advanced Tumor DiseaseNguyen-Son Le0Asli Zeybek1Klaus Hackner2Cornelia Gallauner3Josef Singer4Felix Schragel5Petra Georg6Sandra Gottsauner-Wolf7Martin Pecherstorfer8Gudrun Kreye9Karl Landsteiner University of Health Sciences, Dr Karl-Dorrek-Straße 30, Krems, AustriaDepartment of Internal Medicine, Kantonsspital Zug, Zug, SwitzerlandKarl Landsteiner University of Health Sciences, Dr Karl-Dorrek-Straße 30, Krems, AustriaKarl Landsteiner University of Health Sciences, Dr Karl-Dorrek-Straße 30, Krems, AustriaKarl Landsteiner University of Health Sciences, Dr Karl-Dorrek-Straße 30, Krems, AustriaKarl Landsteiner University of Health Sciences, Dr Karl-Dorrek-Straße 30, Krems, AustriaKarl Landsteiner University of Health Sciences, Dr Karl-Dorrek-Straße 30, Krems, AustriaStrategy and Quality Medicine, Medical Strategy and Development, Landesgesundheitsagentur Niederösterreich, St Pölten, AustriaKarl Landsteiner University of Health Sciences, Dr Karl-Dorrek-Straße 30, Krems, AustriaKarl Landsteiner University of Health Sciences, Dr Karl-Dorrek-Straße 30, Krems, AustriaPURPOSEPalliative radiotherapy (PRT) toward the end of life (EOL) in advanced tumor disease is contentious. Although EOL RT can alleviate cancer-related symptoms, relief typically occurs weeks to months after treatment, potentially compromising the quality of life of patients during the final stages. This study aims to assess factors influencing the decision-making process regarding EOL RT.MATERIALS AND METHODSThis retrospective study of a real-world cohort included 684 consecutive patients with a diagnosis of a solid tumor who died between 2017 and 2021. In these patients, factors potentially influencing the administration of EOL RT were analyzed.RESULTSOf the 684 patients, 164 received PRT, with 60 (36.6%) receiving EOL RT within the last 30 days of life. The median time from the last RT session to death was 55 days. Significant factors influencing EOL RT administration were age ≤65 years (odds ratio [OR], 1.75 [95% CI, 1.02 to 3.01]), Union for International Cancer Control stage IV (OR, 2.77 [95% CI, 1.41 to 5.46]), lung cancer (OR, 2.16 [95% CI, 1.00 to 4.68]), palliative care referral (OR, 1.80 [95% CI, 0.98 to 3.30]), systemic anticancer treatment ≤30 days before death (OR, 1.87 [95% CI, 1.05 to 3.33]), and Eastern Cooperative Oncology Group performance status ≥2 (OR, 3.73 [95% CI, 1.88 to 7.40]). Furthermore, RT near the EOL was more likely administered at multiple sites (OR, 2.08 [95% CI, 1.00 to 4.29]) and with ≤5 fractions (OR, 2.37 [95% CI, 1.23 to 4.57]), while being associated with lower response rates (OR, 0.43 [95% CI, 0.21 to 0.86]) and increased therapy discontinuation (OR, 4.40 [95% CI, 1.45 to 13.37]).CONCLUSIONThese findings highlight varying RT patterns influenced by specific factors, demonstrating the complexity of EOL treatment decisions in advanced cancer care. Identifying key factors for personalized, patient-centered EOL RT decisions warrants further investigation.https://ascopubs.org/doi/10.1200/GO-24-00500 |
| spellingShingle | Nguyen-Son Le Asli Zeybek Klaus Hackner Cornelia Gallauner Josef Singer Felix Schragel Petra Georg Sandra Gottsauner-Wolf Martin Pecherstorfer Gudrun Kreye Palliative Radiotherapy Near the End of Life: An Analysis of Factors Influencing the Administration of Radiotherapy in Advanced Tumor Disease JCO Global Oncology |
| title | Palliative Radiotherapy Near the End of Life: An Analysis of Factors Influencing the Administration of Radiotherapy in Advanced Tumor Disease |
| title_full | Palliative Radiotherapy Near the End of Life: An Analysis of Factors Influencing the Administration of Radiotherapy in Advanced Tumor Disease |
| title_fullStr | Palliative Radiotherapy Near the End of Life: An Analysis of Factors Influencing the Administration of Radiotherapy in Advanced Tumor Disease |
| title_full_unstemmed | Palliative Radiotherapy Near the End of Life: An Analysis of Factors Influencing the Administration of Radiotherapy in Advanced Tumor Disease |
| title_short | Palliative Radiotherapy Near the End of Life: An Analysis of Factors Influencing the Administration of Radiotherapy in Advanced Tumor Disease |
| title_sort | palliative radiotherapy near the end of life an analysis of factors influencing the administration of radiotherapy in advanced tumor disease |
| url | https://ascopubs.org/doi/10.1200/GO-24-00500 |
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