This Article Full Text Full Text (PDF) eLetters: Submit a response to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Archer, V.R. Articles by Cullen, M.H. Search for Related Content PubMed PubMed Citation Articles by Archer, V.R. Articles by Cullen, M.H.

Palliative Chemotherapy: No Longer a Contradiction in Terms

^a Queen Elizabeth Hospital, Birmingham, UK; ^b CRC Institute for Cancer Studies, The Medical School, University of Birmingham, Edgbaston, Birmingham, UK

Correspondence: Michael Cullen, M.D., Cancer Centre at The Queen Elizabeth Hospital, Birmingham, B15 2TH, UK. Telephone: 0121-472-1311; Fax: 0121-627-2496.

Palliative chemotherapy is defined as treatment in circumstances where the impact of intervention is insufficient to result in major survival advantage, but does affect improvement in terms of tumor-related symptoms, and where the palliation/toxicity trade-off from treatment clearly favors symptom relief.

The role of chemotherapy in circumstances where little or no survival benefit is anticipated remains controversial. This is despite the mounting body of evidence in favor of its use for symptom palliation. The notion persists that outcomes other than significant survival benefit are not valid, because of firmly held perceptions of toxicity.

Studies of chemotherapeutic palliation using valid measures of quality of life, show that patients may be willing to accept some side effects of treatment, as long as they gain relief from tumor-related symptoms.

The aims of this review are to present the case for palliative chemotherapy, to highlight the areas of progress which have made this feasible, and to provide guidance with regard to its appropriate use.

Key Words. Antineoplastic agents combined • Antiemetics • Cisplatin • Antimetabolites • Antineoplastic • Quality of life • Bronchial neoplasms

This article has been cited by other articles:

				S. Audrey, J. Abel, J. M Blazeby, S. Falk, and R. Campbell What oncologists tell patients about survival benefits of palliative chemotherapy and implications for informed consent: qualitative study BMJ, July 31, 2008; 337(jul31_3): a752 - a752. [Abstract] [Full Text] [PDF]

				M. P. Davis Integrating palliative medicine into an oncology practice American Journal of Hospice and Palliative Medicine, November 1, 2005; 22(6): 447 - 456. [PDF]

				S. J Bowcock, C. D Shee, S. M B Rassam, and P. G Harper Chemotherapy for cancer patients who present late BMJ, June 12, 2004; 328(7453): 1430 - 1432. [Full Text] [PDF]

				M Cullen Lung cancer * 4: Chemotherapy for non-small cell lung cancer: the end of the beginning Thorax, April 1, 2003; 58(4): 352 - 356. [Abstract] [Full Text] [PDF]

				K. A. Knuti, R. H. Wharton, K. L. Wharton, B. A. Chabner, T. J. Lynch Jr., and R. T. Penson Living as a Cancer Surpriser: A Doctor Tells His Story Oncologist, February 1, 2003; 8(1): 108 - 122. [Abstract] [Full Text] [PDF]