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Comment & Response
January 2016

Evaluating Chemotherapy at the End of Life

Author Affiliations
  • 1Antoni van Leeuwenhoek Hospital–Netherlands Cancer Institute, Amsterdam, the Netherlands
JAMA Oncol. 2016;2(1):143-144. doi:10.1001/jamaoncol.2015.4108

To the Editor In their study on the association between late chemotherapy use and quality of life (QOL) near death as a function of Eastern Cooperative Oncology Group (ECOG) performance status, Prigerson et al1 concluded that patients with late-stage metastatic cancer receiving chemotherapy and with good performance status (ECOG = 1) have worse quality of death (QOD) compared with similar patients who did not receive chemotherapy. In patients with moderate (ECOG = 2) or poor performance status (ECOG = 3), QOD was similar in both groups. Intuitively, these data contradict what one would expect (and American Society of Clinical Oncology guidelines recommend). After careful examination, we raise concerns about the validity of their data, and accordingly, the interpretation of the results.

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