[Aggressiveness of end-of-life care in oncology: Where do we stand? A relevance review in a French Comprehensive Cancer Center].

INTRODUCTION

Aggressiveness of end-of-life care refers to intensive medical interventions at an advanced disease stage, including the late initiation of chemotherapy. This study assesses its incidence among patients hospitalized at the Léon-Bérard Center.

METHODS

This retrospective study was based on a relevance review, according to the criteria defined by the French National Health Authority (HAS) and included 80 patients who died between November 2023 and May 2024. Aggressiveness of care was defined using a composite criterion: (1) chemotherapy within the last 14 days of life; (2) initiation of a new line of therapy within the last month of life; (3) transfer to intensive or critical care within the last month of life; (4) first contact with palliative care less than three days before death.

RESULTS

Among the 75 records analyzed, 36 patients (48%) presented at least one criterion of aggressiveness in end-of-life care. The prevalence was 25.3% for chemotherapy within the last 14 days, 28% for the initiation of a new therapeutic line in the last month, 16% for transfer to intensive or critical care in the last month.

DISCUSSION: Compared to the existing literature, these results indicate high rates of aggressive end-of-life care. They highlight the importance of early palliative care integration to improve care planning and reduce aggressiveness.

CONCLUSION

The use of prognostic tools and improved coordination between oncology and palliative care appear to be essential to optimize end-of-life management.