THE ESTIMATION OF LIFE-TIME FOR THE PATIENTS WHO ACQUIRED RESISTANCE TO STANDARD CHEMOTHERAPIES

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Abstract

Background

Prognostication is important for the advanced cancer patients to make the most for the rest of their life. We examined the accuracy of oncologist clinical predictions of survival (CPS) and the factors that oncologists referred to in cancer patients who acquired resistance to the standard chemotherapies. We also examined how oncologists share the information about the survival with patients and their family.

Methods

Fourteen oncologists treating major adult solid malignancies (breast, lung, gastrointestinal, pancreatic, gynecologic cancer and sarcoma) participated in this observational prospective cohort study between October 2010 and October 2011. The oncologists were asked to fill in the questionnaire about CPS when patients acquired resistance to the standard chemotherapies.

Results

The data of 52 patients were available for analysis. The median CPS was 92 days [interquartile range (IQR), 61–168 days], and the median actual survival (AS) was 80 days (IQR, 35–148 days). The median difference between CPS and AS (|CPS − AS|) was 21 days (IQR, −26 to 50 days). The Spearman correlation between CPS and AS was 0.66 (P < 0.001) and they were highly significantly associated. The proportion of patients with |CPS − AS|; 7, 14 and 28 days were 6, 14 and 42%, respectively. Although age, oral intake, the number of chemotherapy regimens and the prognostic factors that oncologists referred to were not related to |CPS - AS|. Eighteen patients (35%) were informed about the prognosis and 37 patients (71%) were provided with information about the palliative care unit. Thirty-three patients (64%) received best supportive care alone and 18 patients (35%) received further chemotherapies.

Conclusions

Oncologists' predictions generally correlated with AS. As long as the prediction of survival is based on the prognostic factors that oncologists referred to, CPS can be correct to within as least 4 weeks.

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