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10.1001/jamaoncol.2015.2378 http://scihub22266oqcxt.onion/10.1001/jamaoncol.2015.2378 C4828728!4828728!26203912     free     free     free Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       JAMA+Oncol 2015 ; 1 (6): 778-84 Nephropedia Template TP {{tp|p=26203912|t=2015. Chemotherapy Use, Performance Status, and Quality of Life at the End of Life |pdf=|usr=}}{{26203912}} gab.com Text Chemotherapy Use, Performance Status, and Quality of Life at the End of Life JO: JAMA Oncol http://www.kidney.de/pget.php?&tw=1&pmid=26203912 #FOAvip IMPORTANCE: Although many patients with end-stage cancer are offered chemotherapy to improve quality of life (QOL), the association between chemotherapy and QOL amid progressive metastatic disease has not been well-studied. American Society for Clinical Oncology guidelines recommend palliative chemotherapy only for solid tumor patients with good performance status. OBJECTIVE: To evaluate the association between chemotherapy use and QOL near death (QOD) as a function of patients? performance status. DESIGN, SETTING, AND PARTICIPANTS: A multi-institutional, longitudinal cohort study of patients with end-stage cancer recruited between September 2002 and February 2008. Chemotherapy use (n = 158 [50.6%]) and Eastern Cooperative Oncology Group (ECOG) performance status were assessed at baseline (median = 3.8 months before death) and patients with progressive metastatic cancer (N = 312) following at least 1 chemotherapy regimen were followed prospectively until death at 6 outpatient oncology clinics in the United States. MAIN OUTCOMES AND MEASURES: Patient QOD was determined using validated caregiver ratings of patients? physical and mental distress in their final week. RESULTS: Chemotherapy use was not associated with patient survival controlling for clinical setting and patients? performance status. Among patients with good (ECOG score = 1) baseline performance status, chemotherapy use compared with nonuse was associated with worse QOD (odds ratio [OR], 0.35; 95% CI, 0.17-0.75; P = .01). Baseline chemotherapy use was not associated with QOD among patients with moderate (ECOG score = 2) baseline performance status (OR, 1.06; 95% CI, 0.51-2.21; P = .87) or poor (ECOG score = 3) baseline performance status (OR, 1.34; 95% CI, 0.46-3.89; P = .59). CONCLUSIONS AND RELEVANCE: Although palliative chemotherapy is used to improve QOL for patients with end-stage cancer, its use did not improve QOD for patients with moderate or poor performance status and worsened QOD for patients with good performance status. The QOD in patients with end-stage cancer is not improved, and can be harmed, by chemotherapy use near death, even in patients with good performance status. Twit Text FOAVip Chemotherapy Use, Performance Status, and Quality of Life at the End of Life ????JAMA Oncol http://www.kidney.de/pget.php?&tw=1&pmid=26203912 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=26203912 #FOAvip English Wikipedia <ref>{{Cite pmid|26203912}}</ref> Chemotherapy Use, Performance Status, and Quality of Life at the End of Life #MMPMID26203912 Prigerson HG; Bao Y; Shah MA; Paulk ME; LeBlanc TW; Schneider BJ; Garrido MM; Reid MC; Berlin DA; Adelson KB; Neugut AI; Maciejewski PK JAMA Oncol 2015[Sep]; 1 (6): 778-84 PMID26203912show ga IMPORTANCE: Although many patients with end-stage cancer are offered chemotherapy to improve quality of life (QOL), the association between chemotherapy and QOL amid progressive metastatic disease has not been well-studied. American Society for Clinical Oncology guidelines recommend palliative chemotherapy only for solid tumor patients with good performance status. OBJECTIVE: To evaluate the association between chemotherapy use and QOL near death (QOD) as a function of patients? performance status. DESIGN, SETTING, AND PARTICIPANTS: A multi-institutional, longitudinal cohort study of patients with end-stage cancer recruited between September 2002 and February 2008. Chemotherapy use (n = 158 [50.6%]) and Eastern Cooperative Oncology Group (ECOG) performance status were assessed at baseline (median = 3.8 months before death) and patients with progressive metastatic cancer (N = 312) following at least 1 chemotherapy regimen were followed prospectively until death at 6 outpatient oncology clinics in the United States. MAIN OUTCOMES AND MEASURES: Patient QOD was determined using validated caregiver ratings of patients? physical and mental distress in their final week. RESULTS: Chemotherapy use was not associated with patient survival controlling for clinical setting and patients? performance status. Among patients with good (ECOG score = 1) baseline performance status, chemotherapy use compared with nonuse was associated with worse QOD (odds ratio [OR], 0.35; 95% CI, 0.17-0.75; P = .01). Baseline chemotherapy use was not associated with QOD among patients with moderate (ECOG score = 2) baseline performance status (OR, 1.06; 95% CI, 0.51-2.21; P = .87) or poor (ECOG score = 3) baseline performance status (OR, 1.34; 95% CI, 0.46-3.89; P = .59). CONCLUSIONS AND RELEVANCE: Although palliative chemotherapy is used to improve QOL for patients with end-stage cancer, its use did not improve QOD for patients with moderate or poor performance status and worsened QOD for patients with good performance status. The QOD in patients with end-stage cancer is not improved, and can be harmed, by chemotherapy use near death, even in patients with good performance status. äChemotherapy Use, Performance Status, and Quality of Life at the End o(epmc).pdf DeepDyve Pubget Overpricing