对死亡前预后有限的晚期癌症患者进行全身抗癌治疗（SACT）与高毒性和生活质量下降相关。指南不鼓励这种方法，因为它是低价值护理。然而，大量患者在生命的最后 30 天继续接受 SACT。克雷姆斯大学医院进行了一项回顾性研究，包括对 2017 年至 2021 年间被诊断患有实体瘤并死亡的患者进行分析，特别关注临终 (EOL) SACT 的使用。该研究总共纳入了 685 名患者。 SACT 应用于 342 名（49.9%）患者，其中 143 名（41.8%，总人口：20.9%）患者在生命最后 30 天内接受了 SACT。从最后一次 SACT 到死亡的中位时间为 44.5 天。对影响 EOL SACT 给药的潜在因素的分析揭示了以下重要发现：SACT 类型 [P < 0.001，靶向治疗比值比 (OR) 5.09，95% 置信区间 (CI) 2.26-11.48；化疗/靶向治疗 OR 3.60，95% CI 1.47-8.82；免疫检查点抑制剂 OR 2.32，95% CI 1.37-3.92]，没有转诊至姑息治疗 (PC)（P = 0.009，OR 1.86，95% CI 1.16-2.96），没有入住 PC 病房（P < 0.001，OR 2.70） ，95% CI 1.67-4.35)，东部肿瘤合作组 (ECOG) 表现状态不佳（≥2，P < 0.001，OR 3.35，95% CI 1.93-5.83）。EOL 附近的 SACT 时机显着影响几个因素，包括 SACT 类型、转诊至 PC 服务、进入 PC 单元以及 ECOG 表现状态。这些发现强调了晚期癌症护理中治疗决策的复杂性，并强调需要采用以患者为中心的个性化方法，考虑临床和患者相关因素，以优化 EOL 护理。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Systemic anticancer treatment (SACT) for advanced cancer patients with limited prognosis before death is associated with high toxicity and reduced quality of life. Guidelines discourage this approach as low-value care. However, a significant number of patients continue to receive SACT in the last 30 days of life.A retrospective study was carried out at the University Hospital Krems, encompassing the analysis of patients who were diagnosed with a solid tumor and died between 2017 and 2021, with a particular focus on the use of end-of-life (EOL) SACT.A total of 685 patients were included in the study. SACT was applied in 342 (49.9%) patients, of whom 143 (41.8%, total population: 20.9%) patients received SACT within the last 30 days of life. Median time from last SACT to death was 44.5 days. The analysis of potential factors impacting the administration of EOL SACT revealed the following significant findings: type of SACT [P < 0.001, targeted therapy odds ratio (OR) 5.09, 95% confidence interval (CI) 2.26-11.48; chemotherapy/targeted therapy OR 3.60, 95% CI 1.47-8.82; immune checkpoint inhibitor OR 2.32, 95% CI 1.37-3.92], no referral to palliative care (PC) (P = 0.009, OR 1.86, 95% CI 1.16-2.96), no admission to PC ward (P < 0.001, OR 2.70, 95% CI 1.67-4.35), and poor Eastern Cooperative Oncology Group (ECOG) performance status (≥2, P < 0.001, OR 3.35, 95% CI 1.93-5.83).The timing of SACT near the EOL is significantly influenced by several factors, including the type of SACT, referral to PC services, admission to PC unit, and ECOG performance status. These findings underscore the complexity of treatment decisions in advanced cancer care and highlight the need for personalized, patient-centered approaches that consider both clinical and patient-related factors to optimize care at the EOL.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.