241P - The correlates of dose reduction in chemotherapy for patients with common cancers. A prospective study

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer Agents
Translational Research
Basic Principles in the Management and Treatment (of cancer)
Biological Therapy
Presenter Hakan Bozcuk
Citation Annals of Oncology (2014) 25 (suppl_4): iv58-iv84. 10.1093/annonc/mdu326
Authors H. Bozcuk1, M. Yildiz2, S. Uçar1, H. Mutlu1, H. Coskun1
  • 1Dept. Of Internal Medicine, Akdeniz University Medical Oncology, 07058 - Antalya/TR
  • 2Medical Oncology, Antalya Education and Research HospitalTibbi Onkoloji Klinigi, TR-07050 - Antalya/TR



Dose reduction in chemotherapy may compromise survival and chance of cure for cancer patients. It is not clearly known when and for whom clinicians prescribe dose reductions while administering chemotherapy. Our group decided to evaluate prospectively factors that are correlated with chemotherapy dose reduction or occurrence of febrile neutropenia. This report focuses on the correlates of dose reduction in chemotherapy.


Consecutive breast, lung and colorectal cancer patients undergoing chemotherapy at the outpatient units or on the oncology wards, encompassing a period of 4 years (between 2007 and 2011), were prospectively recruited in this study. Two teaching hospitals (one university hospital and one state hospital) collaborated for this project. Local ethical committee approval was obtained prior to onset of the study. Patient, disease, and treatment characteristics were then correlated with the occurrence of any dose reduction during chemotherapy with a certain protocol. Univariate and multivariate logistic regression analyses were carried out to investigate the predictors of chemotherapy dose reduction.


A total of 2928 cycles of chemotherapy in 1089 patients with at least one cycle of prior treatment with the same protocol were investigated. Dose reduction was made in 309 cycles (10.6% of total cycles). The correlates of dose reduction in multivariate analysis were type of hospital (Exp (B) = 45.55, P <0.001), stage of disease (Exp (B) = 0.74, P =0.031), albumin level (Exp (B) = 0.59, P <0.001), thrombocyte count (Exp (B) = 0.99, P =0.002), history of radiotherapy (Exp (B) = 0.61, P =0.001), cycle number of chemotherapy (Exp (B) = 1.38, P <0.001), and a history of febrile neutropenia (Exp (B) = 0.31, P <0.001).


This study suggests some novel correlates of dose reduction in patients receiving chemotherapy for common cancers. It may be beneficial to take these factors into account to personalize the risk for dose reduction as well as to optimize measures to sustain the dosage of chemotherapeutics.


All authors have declared no conflicts of interest.