1643 - Analysis of the association between the number of regimens and the frequency of side effects in outpatients receiving cancer chemotherapy. Can progr...

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Complications/Toxicities of Treatment
Presenter Tomoe Kushihara
Authors T. Kushihara1, K. Kawada2, H. Kushihara1, N. Hamajima3, M. Amano3, K. Ooji3, K. Honda2, F. Nomura2, Y. Ikeda1, K. Mori1
  • 1Pharmacy, Japanese Red Cross Nagoya Daiichi Hospital, 453-8511 - Nagoya/JP
  • 2Medical Oncology, Japanese Red Cross Nagoya Daiichi Hospital, 4538511 - Nagoya/JP
  • 3Nursing, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya/JP



In general, chemotherapy with more than one regimen is carried out sequentially. An increased number of regimens can lead to cumulative, potentially severe side effects. Recently, whether the primary endpoint of phase III clinical trials should be progression-free survival has been actively discussed. With the extension of progression-free survival, late side effects may develop. We investigated whether an increased number of chemotherapeutic regimens is associated with severer side effects.


We retrospectively investigated the incidence of major grade 2 or higher nonhematologic and hematologic toxicities in outpatients who received 1st line, 2nd line, and 3rd line or subsequent cancer chemotherapy between July 2009 and March 2011 at Nagoya Daiichi Red Cross Hospital in Japan.


A total of 924 patients (453 men and 471 women) were studied. The median age was 62 years (range: 2 to 89). The major diagnoses were lung cancer (20.3%), breast cancer (16.7%), lymphoma (12.3%), and colorectal cancer (11.6%). The following data are presented in the order of 1st line, 2nd line, and 3rd line or subsequent therapy. Nonhematologic toxicities were constipation (29, 21, 27%), fatigue (20, 14, 23%), anorexia (14, 13, 18%), neuropathy (13, 16, 18%), nausea (12, 9, 14%), pain (12, 11, 16%), vomiting (6, 6, 11%), diarrhea (5, 6, 11%), dysgeusia (5, 3, 6%), oral mucositis (3, 2, 8%), and nail trouble (2, 3, 6%). Hematologic toxicities were neutropenia (31, 27, 27%), anemia (29, 25, 25%), and thrombocytopenia (6, 1, 0%). Nonhematologic toxicity showed a significant trend to increase in patients who received 3rd line or subsequent therapy (p < 0.01).


The extension of progression-free survival can delay initiation of treatment and lead to the late occurrence of side effects. We consider progression-free survival very useful from the viewpoint of side effects, even in phase III clinical trials.


All authors have declared no conflicts of interest.