Clinical analysis of palliative care alone in end-stage head and neck cancer treatment

There are only a few reports on the terminal clinical course of patients who received palliative care alone. We retrospectively analyzed the clinical records of 130 patients with head and neck cancer who accepted a policy of palliative care alone at our institute between March 2008 and February 2018. Median overall survival （OS） was 3.6 months. Patients’ age, histological type, primary site, palliative treatment or use of opioids did not influence OS. On the other hand, OS was significantly shorter in patients with distant metastasis （p ＝ 0.004）, those who had received second-line chemotherapy （p ＝ 0.033）, intervention by the palliative care team （p ＝ 0.023）, those with steroid use （p ＝ 0.005）, and those who spent their terminal period in our hospital （p ＝ 0.005）. A significant correlation was found between the palliative treatment period and the total period of terminal care （r ＝ 0.631, p ＜ 0.0001）. These results suggest that longer palliative treatment may extend the entire course of the terminal period. Since the survival period of patients with head and neck cancers under palliative care alone is generally short, patients’ quality of life is the most important issue to be addressed in this period.