{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:33:42Z","timestamp":1790724822857,"version":"4.1.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Days spent with healthcare contact during cancer treatment, or \u201ctime toxicity,\u201d may be particularly relevant to patients with end-stage malignancies, including metastatic castrate resistant prostate cancer (mCRPC), considering further cancer-directed therapies near the end-of-life.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and methods<\/jats:title>\n                  <jats:p>We retrospectively assessed healthcare contact days (ie, days with healthcare contact outside the home) in the last 12 months of 96 patients with mCRPC at an academic cancer center. We compared contact days in the 90-day period between 12 and 9 months prior to death (\u201cfirst quarter\u201d) and the 90-day period prior to death (\u201clast quarter\u201d) using the Wilcoxon signed rank test, with additional univariate analyses focused on clinicodemographic variables, particularly systemic treatments.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were higher median [IQR] total contact days in the last vs first quarter (6 [2,17] vs 4 [3,6], P\u2005&amp;lt;\u2005.01), driven by emergency room visits and hospitalizations. Compared to patients off treatment in the first quarter (4 [3,4]), chemotherapy (5 [4,6], P\u2005=\u2005.02) and radiotherapeutics (5 [4,9], P\u2005=\u2005.03) were associated with greater contact days, but not androgen signaling inhibitors (3 [2,5], P\u2005=\u2005.20). However, there were no differences in contact days by treatment in the last quarter. Patients enrolled in hospice experienced similar contact days between the last and first quarters (4 [2,15] vs 4 [3,7], P\u2005=\u2005.22).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Patients with mCRPC experienced increased healthcare contact in the last three months of life resulting from higher inpatient level of care, despite most enrolling in hospice. Future studies can further set expectations on time toxicity in end-stage mCRPC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/oncolo\/oyaf046","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T12:54:10Z","timestamp":1747400050000},"source":"Crossref","is-referenced-by-count":5,"title":["Days spent with healthcare contact by patients with metastatic castrate resistant prostate cancer in the last year of life"],"prefix":"10.1093","volume":"30","author":[{"given":"Daniel","family":"Sentana-Lledo","sequence":"first","affiliation":[{"name":"Dana-Farber Cancer Institute, Harvard Medical School ,\u00a0 Boston, MA 02215 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Barnett","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center, Harvard Medical School ,\u00a0 Boston, MA 02215 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Einstein","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center, Harvard Medical School ,\u00a0 Boston, MA 02215 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0875-4731","authenticated-orcid":false,"given":"Arjun","family":"Gupta","sequence":"additional","affiliation":[{"name":"Masonic Cancer Center at the University of Minnesota , Minneapolis, MN 55455 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia K","family":"Morgans","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Harvard Medical School ,\u00a0 Boston, MA 02215 ,","place":["United 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