Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our oncology ward for management of metabolic toxicities.
We did this cross-sectional analysis over a period of seven months (January-July 2013) for all those patientswho while undergoing anti-cancer therapy in our institute with a curative intent got admitted to our oncology in-patient ward with some sort of metabolic toxicity. Grading of toxicity was done using National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0.
A total of 14 events of metabolic toxicities were noted in 12 patients over this period. The most common of them were hyponatremia (grade ≤2: 3; grade ≥3: 2). The others were hypokalemia (n = 4, all grade ≤2), hypercalcemia (n = 2, both grade 2), grade 2 hypomagnesaemia (n = 1), diabetic keto-acidosis (n = 1) and hyperkalemia (n = 1; grade 2). None of these toxicities reached the severity of grade 5. The distribution of different primary malignancies among these patients have been shown in table-1. The median duration of hospital stay for managing these toxicities were 6.4 days (range: 3-11 days). Treatment interruption took place in four patients. The median duration of interruption was 4.5 days (range: 3-10 days).All these patients were managed successfully.
|Hyponatremia||lung: 2 Glioblastoma: 1 Seminoma: 2|
|Hypokalemia||lung: 1 rectum: 1 Sarcoma: 1 cervix: 1|
|Hypercalcemia||lung: 1 CUP with skeletal metastasis: 1|
|Diabetic keto-acidosis||breast: 1|
Such studies show the prevailing practice from institutes of our country and may guide us formulating a guideline for managing such toxicities for this part of the world.
Clinical trial identification
All authors have declared no conflicts of interest.