Aggressive anticancer treatment in the last 2 weeks of life

Sep 21, 2026

Study evaluates how often terminally ill advanced solid cancer patients receive systemic therapy, radiotherapy, and surgery during the final 2 weeks of life, and how this relates to year of death, age, sex, prognosis, and enrollment into specialist palliative care. A retrospective cohort of 1736 decedents from 2015–2019 used multiple logistic regression to quantify treatment aggressiveness. Results show increasing odds over time, higher use of novel systemic therapies, and lower odds among older patients and those in SPC; younger and non-SPC patients are at greater risk.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Background

Materials and methods

Results

Key findings

Conclusions

Introduction

Prognosis, end-of-life criteria, and treatment risk

ORIGINAL RESEARCH Aggressive anticancer treatment in the last 2 weeks of life N. Golob1, 2, T. Oblak3, L. avka1, 4, M. Kuar5 & B. eruga1, 6􀀁 1Faculty of Medicine, University of Ljubljana, Ljubljana; 2Department of Acute Palliative Care, Institute of Oncology Ljubljana, Ljubljana; 3Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Ljubljana; 4Department of Oncology, University Medical Center Maribor, Maribor; 5Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana; 6Division of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia Available online xxx Background: There is a concern that terminally ill cancer patients may be aggressively treated due to the rapidly growing possibilities of anticancer treatment. The aim of this study was to evaluate the use of anticancer treatment at the end of life (EoL) . Materials and methods: This retrospective study included adult patients with advanced solid cancers who were treated at the Institute of Oncology Ljubljana and died of cancer between January 2015 and December 2019 . A multiple logistic regression model was used to assess an association between the aggressiveness of anticancer treatment (i.e. systemic therapy, radiotherapy and surgery) in the last 2 weeks of life and year of death, age at death, sex, prognosis of cancer and enrolment into the specialist palliative care (SPC) . Results: We included 1736 patients in our analysis. Overall, 13 .7% of patients were enrolled into the SPC and 14 .4% received anticancer treatment in the last 2 weeks of life. The odds of receiving anticancer treatment signiﬁcantly increased over time [odds ratio (OR) 1 . 15, 95% conﬁdence interval (CI) 1 .04-1. 27] . There was an increased use of novel systemic therapy (e.g. small-molecule targeted therapy and immunotherapy) at the EoL. Older patients had signiﬁcantly lower odds to receive anticancer treatment in the last 2 weeks of life as compared to younger patients (OR 0 .96, 95% CI 0 .95-0.98) . As compared to patients receiving only a standard oncology care, those also enrolled into the SPC had signiﬁcantly lower odds for anticancer treatment in the last 2 weeks of life (OR 0 . 22, 95% CI 0 .12-0.43) . Conclusions: Terminally ill cancer patients have increased odds for receiving anticancer treatment, especially novel systemic therapies, in the last 2 weeks of life. Younger patients and those not enrolled into the SPC are at particular risk for anticancer treatment at the EoL. Key words: aggressive, anticancer treatment, systemic therapy, specialist palliative care, end of life INTRODUCTION Anticancer treatment can be recommended to patients with advanced cancer with an aim to improve quality of life (QoL) irrespective of its impact on survival.1,2 However, it is well known that anticancer treatment, such as palliative chemotherapy (ChT), can have a detrimental effect on QoLat the end of life (EoL) .3 The two most commonly deﬁning features for EoL are life-limiting disease with irreversible decline and expected survival in terms of months or less.4 The clinicians’ prediction of survival in patients with advanced cancer is often inaccurate and too optimistic.5 Although several prognostic tools were developed and validated to reduce the inaccuracy of clinicians’ prediction *Correspondence to: Assoc. Prof. Botjan eruga, Division of Medical Oncology, Institute of Oncology Ljubljana, Zaloka cesta 2, 1000 Ljubljana, Slovenia. Tel: þ386-1-5879-282 E-mail: [bseruga@onko-i.si](bseruga@onko-i.si) (B. eruga). 2059-7029/© 2024 The Author(s). Published by Elsevier Ltd on behalf of European Society for Medical Oncology. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)). of survival, there is currently no consensus on the most appropriate tool to be used in everyday clinical practice.6

FAQs

What was the study’s objective regarding anticancer treatment at the end of life?

To evaluate how anticancer treatment in the last 2 weeks of life is associated with year of death, age, sex, prognosis, and enrollment into specialist palliative care.

How was aggressiveness of anticancer treatment defined in the study?

By the use of systemic therapy, radiotherapy, and surgery during the last 2 weeks of life.

What patient groups showed higher or lower odds of receiving treatment in the last 2 weeks?

Odds increased over time, were lower for older patients, and were lower for patients enrolled into specialist palliative care compared with those receiving only standard oncology care; younger and non-SPC patients were at particular risk.

Sep 21, 2026

Upload by Lucas Martin