晚期癌症患者的临终讨论得到国际推荐，以确保临终关怀与患者的价值观保持一致。本研究旨在研究与临终关怀相关的临终讨论要素。我们进行了一项前瞻性观察性研究，对象为连续获得一线化疗失败后的预治疗非小细胞肺癌患者。我们在基线时询问了肿瘤学家是否曾与患者讨论过“预后”、“不进行复苏”、“临终关怀”和“偏爱的死亡地点”。使用经验证的问卷在基线和3个月后评估了患者的生活质量（QOL）和抑郁症状。使用医疗记录调查了患者接受的临终关怀情况。还使用问卷评估了肿瘤学家的同情心和看护者对临终关怀的偏好。进行多重回归分析，以研究临终讨论要素与患者报告的结果以及实际临终关怀之间的关联。我们在基线获得了200份有效回应，在3个月后获得了147份有效回应，在临终阶段的医疗护理方面得到了145个数据点。患者与他们的肿瘤学家之间的临终讨论要素与患者报告的结果或实际临终关怀之间没有显著关联。此外，肿瘤学家的同情心与综合QOL和抑郁症状的改善之间存在显著关联，看护者对临终关怀的偏好和高教育水平与临终于临终关怀有显著关联。肿瘤学家与患者的联盟以及看护者对临终讨论的参与可能对实现最佳临终关怀具有影响力。© 2023作者。由牛津大学出版社发布。

End-of-life discussions for patients with advanced cancer are internationally recommended to ensure consistency of end-of-life care with patients' values. This study examined the elements of end-of-life discussions associated with end-of-life care.We performed a prospective observational study among consecutive patients with pretreated non-small cell lung cancer after the failure of first-line chemotherapy. We asked oncologists whether they had ever discussed "prognosis," "do not attempt resuscitation," "hospice," and "preferred place of death" with a patient at baseline. The quality of life (QOL) and depressive symptoms of patients were assessed using validated questionnaires at baseline and 3 months later. The end-of-life care that patients received was investigated using medical records. Oncologists' compassion and caregivers' preferences for hospice care were also assessed using questionnaires. Multiple regression analyses were conducted to examine the association between elements of end-of-life discussions and patient-reported outcomes as well as actual end-of-life care.We obtained 200 valid responses at baseline, 147 valid responses 3 months later, and 145 data points for medical care at the end-of-life stage. No element of the end-of-life discussion between the patient and their oncologist was significantly associated with patients' reported outcomes or actual end-of-life care. In addition, oncologists' compassion was significantly associated with improvement in both comprehensive QOL and depressive symptoms, and caregivers' preferences for hospice care and high educational level were significantly associated with hospice death.Oncologist-patient alliances and caregivers' involvement in end-of-life discussions may be influential in achieving optimal end-of-life care.© The Author(s) 2023. Published by Oxford University Press.