Évaluation des pratiques dans un centre de lutte contre le cancer concernant l’utilisation des traitements systémiques en fin de vie chez les patients atteints d’un cancer métastatique

Examining the use of palliative systemic treatments near end-of-life for patients with metastatic cancer at a French cancer institute Background and objectives > Appropriate use of palliative systemic treatments near end-of-life is crucial to reduce aggressiveness of cancer care. The study's objective is to evaluate cancer quality -of-care near end-of-life in our cancer institute. Methods > From a retrospective cohort, we included all adults with metastatic solid cancers who died in 2019. The use of palliative systemic treatments close to death was measured from quality -of-care indicators described by Earle and al. The integration of supportive care into standard oncology care was also evaluated. All the information were collected from electronic records. Results > Of the 452 patients, 6.2% received systemic treatment in the last 14 days of life and 8.4% started a new systemic treatment in the last 30 days of life. Eighty six percent met a supportive care physician. This intervention was significantly less frequent in the TS<14 group than in the TS>30 group (71.4 % vs 89.5 % p = 0.021). The main reasons for first contact were pain (35 %), early palliative care (29 %) and then exclusive palliative care (17.5 %). Conclusion > Our institute offers a good quality of end-of-life care for patients with metastatic solid cancers. However, improvements should be done regarding prognostic estimation and integration of palliative care.