Evaluation of current practice

Abstract

Adverse effects induced by cytotoxic chemotherapy (CT) have been mostly evaluated in clinical trials. The aim of this study was to assess in a nonselected patients group the incidence of CT-related toxicities and to identify risk factors in daily practice. Patients treated with CT (except cisplatin-based or carboplatin-based CT), for a solid tumour, were included in a prospective multicentre observational study. Clinical parameters, renal function and albumin level were assessed at baseline. Multivariate logistic regression was used to identify risk factors of CT-related toxicities. A total of 502 patients were recruited in different types of oncology departments. During CT, 62% of patients experienced grade 2-4 toxicities. Haematological toxicities affected 34% of patients and 20% of patients developed an infection requiring antibiotics. For 55% of patients, toxicities induced dose reduction (59% of cases), CT delay (25%) or discontinuation (16%) according to the management habits in the investigating centre. Performance status≥1, breast cancer, lymphopenia, hypoalbuminaemia and clearance creatinine<60 ml/min were risk factors for haematological toxicity. Performance status≥1, hypoalbuminaemia, proteinuria and clearance creatinine<90 ml/min were risk factors for change of CT schedule. A majority of patients receiving CT experienced significant toxicity leading to change of standard CT protocol. Albumin, creatinine clearance and lymphocyte should be routinely monitored at baseline to manage CT and to prevent their toxicities.

Association between Single Nucleotide Polymorphisms (SNPs) and Toxicity of Advanced Non-Small-Cell Lung Cancer Patients Treated with Chemotherapy

“…Lethal chemotherapy toxicities are not frequent but do happen in our daily practice [5]. Although cytotoxic chemotherapy improves survival compared with best supportive care in advanced NSCLC, its advantage may be hampered by clinically relevant toxicities [6].…”

Baseline quality of life and chemotherapy toxicities in patients with early breast cancer

“…9,10 Conversely, some baseline clinical predictive factors of chemotherapy toxicities have been well identified, such as age, PS, low white blood cells, lymphopenia, a history of infectious diseases, high blood pressure, and cardiovascular comorbidity. [11][12][13] However, the potential influence of other parameters, such as psychosocial or QoL dimensions, on chemotherapy toxicity has been poorly explored, [13][14][15] and it might be hypothesized that baseline QoL status may exert its detrimental prognosis effect through limitations of effective therapies.…”

Transarterial oily chemoembolization with lidamycin shows potent therapeutic efficacy in VX2 rabbit liver tumor

“… 5 , 6 The therapeutic efficacy of chemotherapy via intravenous injection is often not considered due to the low intratumoral drug concentration resulting from dilution in the blood, inevitably accompanied by severe systemic chemotherapeutic side effects, such as hair loss, nausea, vomiting, and bone marrow suppression. 7 Local radiotherapy as a treatment option for HCC is subject to limitations due to the invisible foci or tumors located near large blood vessels in the liver. 8 In addition, the effective dosage of radiation must be larger than 60 Gy; however, the tolerated radiotherapy dosage of normal liver tissue is less than 40 Gy.…”