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Patterns of chemotherapy-associated toxicity and supportive care in US oncology practice: a nationwide prospective cohort study.

Culakova E, Thota R, Poniewierski MS, Kuderer NM, Wogu AF, Dale DC, Crawford J, Lyman GH - Cancer Med (2014)

Bottom Line: Neutropenic complications remain an important dose-limiting toxicity of cancer chemotherapy-associated with considerable morbidity, mortality, and cost.Chemotherapy-associated toxicities were captured in up to four treatment cycles including severe neutropenia, febrile neutropenia, and infection.A significant inverse relationship was observed between reductions in neutropenic and infectious events and increased utilization of measures to reduce these complications in subsequent cycles.

View Article: PubMed Central - PubMed

Affiliation: Duke University, Durham, North Carolina.

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Related in: MedlinePlus

Cycle-specific neutropenic and infection events during chemotherapy treatment cycles for all patients (A) and among lymphoma (B), early stage (C), or late stage solid tumor (D) patients.
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fig01: Cycle-specific neutropenic and infection events during chemotherapy treatment cycles for all patients (A) and among lymphoma (B), early stage (C), or late stage solid tumor (D) patients.

Mentions: The highest occurrence of neutropenic and infectious events occurred in cycle 1 (Fig. 1) with a substantial decrease seen in subsequent cycles. FN events decreased from 6.4% in cycle 1 to 3.8% and 2.9% in cycles 2 and 3, respectively. In comparison, compound events of febrile and/or severe neutropenia (FN/SN) decreased from 20% in cycle 1 to 14% in cycle 2 and stayed approximately stable at this lower level with 13.5% and 14.3% in cycles 3 and 4, respectively. This decreasing trend of neutropenic events in subsequent cycles was uniformly noted in patients with lymphoma, early-stage solid tumors, or stage IV solid tumors. However, the incidence of FN/SN events in each cycle was influenced by cancer type and disease stage, with first cycle neutropenic event rates of 23.8% in lymphoma, 22.6% in stage I–III solid tumors, and 13.1% in stage IV solid tumors. Similarly, during the subsequent cycles (2, 3, and 4), lower occurrences of FN/SN were observed in patients with stage IV solid tumors (9.2%, 9.8%, 7.8%) compared to patients with stage I–III solid tumors (16.6%, 14.4%, 16.3%) or lymphoma (15.0%, 16.2%, 16.3%). Febrile and infectious events followed a comparable trend.


Patterns of chemotherapy-associated toxicity and supportive care in US oncology practice: a nationwide prospective cohort study.

Culakova E, Thota R, Poniewierski MS, Kuderer NM, Wogu AF, Dale DC, Crawford J, Lyman GH - Cancer Med (2014)

Cycle-specific neutropenic and infection events during chemotherapy treatment cycles for all patients (A) and among lymphoma (B), early stage (C), or late stage solid tumor (D) patients.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3987093&req=5

fig01: Cycle-specific neutropenic and infection events during chemotherapy treatment cycles for all patients (A) and among lymphoma (B), early stage (C), or late stage solid tumor (D) patients.
Mentions: The highest occurrence of neutropenic and infectious events occurred in cycle 1 (Fig. 1) with a substantial decrease seen in subsequent cycles. FN events decreased from 6.4% in cycle 1 to 3.8% and 2.9% in cycles 2 and 3, respectively. In comparison, compound events of febrile and/or severe neutropenia (FN/SN) decreased from 20% in cycle 1 to 14% in cycle 2 and stayed approximately stable at this lower level with 13.5% and 14.3% in cycles 3 and 4, respectively. This decreasing trend of neutropenic events in subsequent cycles was uniformly noted in patients with lymphoma, early-stage solid tumors, or stage IV solid tumors. However, the incidence of FN/SN events in each cycle was influenced by cancer type and disease stage, with first cycle neutropenic event rates of 23.8% in lymphoma, 22.6% in stage I–III solid tumors, and 13.1% in stage IV solid tumors. Similarly, during the subsequent cycles (2, 3, and 4), lower occurrences of FN/SN were observed in patients with stage IV solid tumors (9.2%, 9.8%, 7.8%) compared to patients with stage I–III solid tumors (16.6%, 14.4%, 16.3%) or lymphoma (15.0%, 16.2%, 16.3%). Febrile and infectious events followed a comparable trend.

Bottom Line: Neutropenic complications remain an important dose-limiting toxicity of cancer chemotherapy-associated with considerable morbidity, mortality, and cost.Chemotherapy-associated toxicities were captured in up to four treatment cycles including severe neutropenia, febrile neutropenia, and infection.A significant inverse relationship was observed between reductions in neutropenic and infectious events and increased utilization of measures to reduce these complications in subsequent cycles.

View Article: PubMed Central - PubMed

Affiliation: Duke University, Durham, North Carolina.

Show MeSH
Related in: MedlinePlus