For some patients with advanced cancer, chemotherapy is no longer effective. Symptom relief and palliative care should become the primary modes of care. The Eastern Cooperative Oncology Group (ECOG) performance status is a valid predictor of poor survival, reduced response, and worsened toxicity from chemotherapy. Patients with advanced solid tumours, with an ECOG performance status of 3 or 4, generally exhibit a poor response to chemotherapy. There are well known exceptions to this. These are generally patients with untreated highly chemo-sensitive malignancies, and who have recently declined from a good performance status.
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