{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:59:20Z","timestamp":1781614760487,"version":"3.54.5"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cancer Res Clin Oncol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Systemic anticancer treatments (SACTs) are used in advanced cancer stages to control disease and improve survival. However, their use at the end of life (Eol) can lead to side effects. This study aims to assess the clinical implications of SACTs near the Eol in patients with recurrent\/metastatic head and neck squamous cell carcinoma (R\/M HNSCC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is an observational retrospective study conducted at Fondazione IRCCS Istituto Nazionale dei Tumori di Milano. R\/M HNSCC patients treated from 2016 to 2024 were included and classified based on the timing of their last SACT relative to death: within 30\u00a0days (Cohort 1), and more than 30\u00a0days before death (Cohort 2). Cohort 1 was further subdivided into treatments given 15\u201330\u00a0days (1a) or within 14\u00a0days (1b) before death. We assessed performance status, survival outcomes, time from last therapy administration to death, fatal acute adverse events, and palliative care referral rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred fifty-five patients were evaluable for the analysis. Patients receiving last anticancer therapy within 30\u00a0days of death exhibited worse overall survival compared to those who received their last treatment earlier (HR\u2009=\u20090.69; 95% CI 0.48\u20131.00;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047). Fatal acute events occurred in 31% of cases, with respiratory failure and major bleeding as leading causes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SACTs within 30\u00a0days of death correlates with worse prognosis and more aggressive disease. Major bleeding may be treatment-related when administered within 14\u00a0days of death. These findings emphasize the need for careful patient selection and early palliative care integration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00432-025-06297-5","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T03:34:50Z","timestamp":1756438490000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Systemic anticancer therapy during end of life in head and neck squamous cell carcinoma patients. A retrospective single center study."],"prefix":"10.1007","volume":"151","author":[{"given":"Simone","family":"Rota","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Buriolla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Franza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Cavalieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiana","family":"Bergamini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Alfieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imperia","family":"Nuzzolese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Colombo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Ottini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Lombardi Stocchetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Massa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto","family":"Caraceni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Licitra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Resteghini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"issue":"9","key":"6297_CR1","doi-asserted-by":"publisher","first-page":"2844","DOI":"10.1002\/hed.26772","volume":"43","author":"C Bergamini","year":"2021","unstructured":"Bergamini C, Ferris RL, Xie J et al (2021) Bleeding complications in patients with squamous cell carcinoma of the head and neck. 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Lisa Licitra: Financial Interests, Personal, Advisory Board, for expert opinion in advisory boards: AstraZeneca, Bayer, BMS, Eisai, MSD, Boehringer Ingelheim, Hoffmann-La Roche Ltd., Novartis, Roche, Debiopharm International SA, Sobi, Incyte Biosciences Italy srl, Doxa Pharma srl, Amgen, Nanobiotics, GSK, Alentis; Financial Interests, Institutional, Research Grant, Funds received by my institution for clinical studies and research activities in which I am involved: AstraZeneca, BMS, Boehringer Ingelheim, Celgene International, Eisai, Exelixis, Debiopharm International SA, Hoffmann-La Roche Ltd., IRX Therapeutics, Medpace, Merck-Serono, Merck Healthcare KGaA, MSD, Novartis, Pfizer, Roche, Adlai Nortye; Financial Interests, Institutional, Invited Speaker, Funds received by my institution for clinical studies and research activities in which I am involved: Alentis; Non-Financial Interests, Personal, Member: AIOM, ASCO, ESTRO, EORTC; Non-Financial Interests, Personal, Leadership Role: AIOCC. All other authors have declared no conflicts of interest. Giacomo Massa: 2023 LEO Pharma travel grant. 2024 Merck editorial fees Augusto Caraceni: A.C. has received honoraria from Pierre Fabre, Sandoz, Italfarmaco, Molteni, and Ipsen Spa institutional grant. The sponsors had no role in the interpretation or writing of the study. All other authors have no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of National Cancer of Milan (INT 85\/23).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}],"article-number":"240"}}