Administration of chemotherapy to advanced lung cancer patients near the end of life

Chemotherapy administered near the end of life is often ineffective and toxic but has not been studied in advanced lung cancer patients in Japan. We retrospectively evaluated patients with advanced lung cancer given chemotherapy at our hospital and dying between January and December 2016. A total of 93 patients were included. Thirty-five had been treated with one chemotherapy regimen, 27 with two, 14 with three, and 8 with four, 6 with five, 2 with six, 1 with eight. Forty-six patients were diagnosed with adenocarcinoma without EGFR mutations, 18 with adenocarcinoma harboring EGFR mutations, 20 with small-cell lung cancer, and nine with squamous cell carcinoma. A total of 74.2% of patients received chemotherapy during the last 3 months of life, 58.1% during the last 2 months, 38.7% during the last month, and 11.8% during the last 2 weeks. The median duration of last-line chemotherapy was 0.95 months (0-27.1 months). The median time between the last dose of chemotherapy and death was 46 days (3-887 days). Compared with European reports, nearly twice as many patients received chemotherapy near the end of life, and the percentage was high in patients with >2 regimens. There were no significant differences in tumor histology. The percentage of patients given chemotherapy near the end of life was high in patients with advanced lung cancer. Further study is necessary to determine appropriate near end-of-life chemotherapy.