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Palliative chemotherapy for breast cancer: A population-based cohort study of emergency hospital admissions and place of death

Bright, Chloe J; Dunlop, Casey; Chen, Cong; Smittenaar, Rebecca; McPhail, Sean; Hanbury, Georgina; Dodwell, David; ... Kipps, Emma; + view all (2022) Palliative chemotherapy for breast cancer: A population-based cohort study of emergency hospital admissions and place of death. European Journal of Cancer Care , 31 (4) , Article e13598. 10.1111/ecc.13598. Green open access

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Abstract

OBJECTIVE: Patients with incurable breast cancer may be treated with chemotherapy to improve cancer-related symptoms, quality of life and survival. We examined the association between use of palliative chemotherapy towards the end of life in breast cancer patients and outcomes including unplanned hospital admission and place of death. METHODS: A total of 10,966 women, treated with palliative chemotherapy for breast cancer (diagnosed 1995–2017 in England) within the 2 years prior to death (death between 2014 and 2017), were analysed. Logistic regression (outcome = emergency hospital admission in last 90 days of life yes/no; outcome = place of death hospital/other) was performed, adjusting for line of palliative chemotherapy in the last 90 days of life and patient demographics. RESULTS: The odds of hospital admission reduced with increasing line of chemotherapy received (1st line odds ratio [OR] = 2.7, 2nd line OR = 2.1, 3rd line OR = 1.9, 4th+ line OR = 1.7; baseline chemotherapy) in last 90 days of life. A similar relationship was observed for hospital death (1st line OR = 2.4, 2nd line OR = 2.1, 3rd line OR = 1.7, 4th+ line OR = 1.5). CONCLUSION: This study finds palliative chemotherapy towards the end of life to be associated with increased odds of unplanned hospital admissions and hospital death. These findings can be used to inform discussions between patients and healthcare professionals towards the end of life.

Type: Article
Title: Palliative chemotherapy for breast cancer: A population-based cohort study of emergency hospital admissions and place of death
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/ecc.13598
Publisher version: https://doi.org/10.1111/ecc.13598
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Breast cancer, emergency hospital admissions, end of life morbidity, palliative chemotherapy, place of death
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10159878
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