Purpose <p>The continuation or discontinuation of oncological care is a critical consideration, particularly due to its implications for quality of life at the end of life. We evaluated the management of cancer patients during the final 90&#xa0;days of life by measuring the intensity of care and assessing its overall impact.</p> Method <p>Characterize care pathways and patient status during the last 90&#xa0;days of life, including a survival analysis based on Charlson and BARBOT (Pronopall) scores. Care intensity was evaluated using a composite score based on hospitalizations, emergency visits, and ICU admissions. We also compared chemotherapy-treated and untreated patients in terms of survival, care intensity, polypharmacy, and healthcare resource use, focusing on hospitalization and chemotherapy-related costs.</p> Results <p>In total, 270 patients with a median age of 69 (23–96) years were included. During the last 90&#xa0;days of life, most patients (67.8%) had one or no indicators of high-intensity care. Chemotherapy was administered to 195 patients (72.2%), 80 patients (29.6%) were hospitalized more than once, 38 (14.1%) had multiple emergency department visits, and 5 (1.9%) were admitted to intensive care. Patients who received treatment were significantly younger (p = 0.0058) and in better general condition (p = 0.0129). They were more frequently hospitalized (<i>p</i> = 0.0039), and death occurred more often in hospital wards (<i>p</i> = 0.0223). The total cost of care was significantly higher for treated patients.</p> Conclusion <p>Our findings emphasize the pivotal and potentially detrimental role of chemotherapy administration at the end of life.</p>