Palliative care use and end-of-life care quality in HR+/HER2- metastatic breast cancer.

IF 3 3区医学 Q2 ONCOLOGY

Breast Cancer Research and Treatment Pub Date : 2025-11-01 Epub Date: 2025-08-16 DOI:10.1007/s10549-025-07805-4

Julia G Cohn, Susan C Locke, Kris W Herring, Susan F Dent, Thomas W LeBlanc

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引用次数: 0

Abstract

Purpose: Metastatic breast cancer (MBC) is incurable, despite therapeutic advances, especially in hormone receptor positive (HR+) and human epidermal growth factor-2 negative (HER2-) disease. Specialist palliative care (SPC) is recommended to alleviate distress and reduce overly aggressive end-of-life (EoL) care. This study determined rates of SPC, hospice utilization, and aggressive EoL care in patients with HR+/HER2- MBC.

Methods: A retrospective review was performed of patients with treatment naïve HR+/HER2- MBC treated with endocrine therapy and/or cyclin-dependent kinase 4 and 6 inhibitors at Duke Cancer Institute between January 2012 and December 2017. Variables pertaining to SPC and hospice use and EoL care outcomes up to March 2024 were collected. SPC and hospice utilization and EoL care data were analyzed with descriptive statistics.

Results: Of 102 patients, 85 died during the study period, and over half (55%) received aggressive EoL care. Half had some form of SPC, and rates of aggressive EoL care were comparable between those who engaged with SPC and those who did not. The most common indicators of aggressive EoL care included multiple ED visits (28%) and hospital admissions (23%) in the last 30 days of life as well as in-hospital location of death (24%). Although 72% enrolled in hospice care, 9% of patients were on hospice for ≤ 3 days.

Conclusion: This real-world study demonstrates that many patients with HR + /HER2- MBC receive aggressive EoL care despite some engaging with SPC and many enrolling in hospice. Interventions to decrease aggressive EoL care are needed for this population.

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在HR+/HER2转移性乳腺癌中姑息治疗的使用和临终关怀质量。

目的：转移性乳腺癌（MBC）是不可治愈的，尽管治疗进展，特别是在激素受体阳性（HR+）和人表皮生长因子-2阴性（HER2-）疾病。专家姑息治疗（SPC）建议减轻痛苦和减少过度积极的临终关怀（EoL）。本研究确定了HR+/HER2- MBC患者的SPC率、安宁疗护使用率和积极的EoL护理。方法：回顾性分析2012年1月至2017年12月在杜克癌症研究所接受内分泌治疗和/或细胞周期蛋白依赖性激酶4和6抑制剂治疗的naïve HR+/HER2- MBC患者。有关SPC和临终关怀使用和EoL护理结果的变量收集到2024年3月。SPC与安宁疗护利用及EoL照护资料采用描述性统计分析。结果：102例患者中，85例在研究期间死亡，超过一半（55%）的患者接受了积极的EoL治疗。一半的人有某种形式的SPC，积极的EoL护理率在参与SPC的人和没有参与SPC的人之间是相当的。积极EoL治疗的最常见指标包括生命最后30天内多次急诊科就诊（28%）和住院（23%）以及院内死亡地点（24%）。虽然72%的患者接受了安宁疗护，但9%的患者接受安宁疗护的时间≤3天。结论：这项现实世界的研究表明，许多HR + /HER2- MBC患者接受了积极的EoL治疗，尽管一些患者接受了SPC治疗，许多患者接受了临终关怀。这一人群需要采取干预措施来减少侵略性的EoL护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Cancer Research and Treatment 医学-肿瘤学

CiteScore

6.80

自引率

2.60%

发文量

342

审稿时长

1 months

期刊介绍： Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.