Cancer treatments within the last few weeks of life are unlikely to meaningfully add to quality of life, while causing potential toxicities and adding to health care costs. Australian data has previously been restricted to single institutions. Chemotherapy and radiotherapy delivery rates of 5-20% and 5-10% have been reported respectively. The aim of this study was to report a population-based analysis of both radiotherapy and chemotherapy delivery rates within the last 30 days of life.
The Evaluation of Cancer Outcomes (ECO) Registry records clinical information on all newly diagnosed cancer patients for the Barwon South West Region of Victoria. The registry encompasses a population of approximately 380,000 people. Dates of diagnosis, tumour type and stage as well as core treatment details and date of death are recorded.
During the period of 2009-2014 inclusive there were a total of 11,196 new cancers diagnosed. Chemotherapy was received by 3501 (31%) of patients and radiotherapy by 3325 (30%). A total of 236 (7%) and 181 (5%) patients died within 30 days of receiving chemotherapy and radiotherapy respectively. Factors more likely to be associated with death within 30 days of any treatment were male gender (p<0.01), age greater than 70 years (p<0.01), single patients (p=0.01) and public patients (p=0.04). Patients dying within 30 days of treatment were more likely to have higher stage disease and have been referred to a palliative care service.
To our knowledge, this is the first population-based analysis of chemotherapy and radiotherapy treatment within the last 30 days of life within a region of Australia. The treatment rates are towards the lower range but generally in line with the range of previously published Australian studies and suggest relatively consistent patterns of care across different regions and institutions.