Chemotherapy for advanced cancers

The use of palliative chemotherapy in patients with advanced cancers is complex. Palliative chemotherapy has been associated with increased risk of cardiopulmonary resuscitation and death in an intensive care unit (ICU) (1,2). However, the length of survival for patients with advanced cancer depends on the type of malignancy and its sensitivity to chemotherapy, but is generally worse than for patients without advanced cancer (Figure 1). The goals of chemotherapy for incurable cancer are prolongation of life, alleviation of symptoms, and maintenance or improvement in quality of life (QOL), despite the toxicity associated with treatment. Important factors for treatment decisions also include the patient’s preferences, comorbidities, and performance status (PS), a measure of a patient’s activity level and general well-being (Figure 2). The indications and benefits for chemotherapy (Table 1, Figure 3) need to be continually reassessed to ensure the risk-benefit ratio favors treatment (Figure 4)