• Bhumsuk Keam, Do-Youn Oh, Se-Hoon Lee, Dong-Wan Kim, Mi Ra Kim, Seock-Ah Im, Tae-You Kim, Yung-Jue Bang, and Dae Seog Heo.
• Department of Internal Medicine, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu, Seoul 110-744, Republic of Korea.
• Jpn. J. Clin. Oncol. 2008 May 1;38(5):381-6.

ObjectiveThe aim of this study was to examine the appropriateness of chemotherapy and care in Korean cancer patients near the end-of-life.MethodsWe designed a retrospective cohort composed of patients diagnosed as having metastatic cancer and who received palliative chemotherapy at Seoul National University Hospital in 2002. Two hundred and ninety-eight patients who died of cancer were evaluated in terms of the appropriateness of the cancer-care they received, including chemotherapy.ResultsMedian duration of chemotherapy was 6.02 months compared with 8.67 months for median overall survival. The median period between last chemotherapy and death was 2.02 months. Of the 298 patients, 50.3% received chemotherapy during the last 2 months of life. Furthermore, 17 patients (5.7%) died within 2 weeks after receiving chemotherapy. The proportion who visited an emergency room (ER) more than once during the last months of life was 33.6%, and the average number of ER visits after a diagnosis of cancer was 1.72. Only 9.1% of patients were referred to a hospice consultation service and only 11.7% of patients agreed with written DNR.ConclusionsAmong patients who died of cancer, significant proportions were found to have received chemotherapy up to the end-of-life and to have visited ERs. Hospice referrals and discussions about DNR were not conducted well during the end-of-life period in Korea.

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