Metabolic toxicity in patients undergoing radical anti-cancer therapy: a cross-sectional analysis of patients in an oncology ward in India

Date

20 Dec 2015

Session

Poster presentation 2

Presenters

Subhash Gupta

Citation

Annals of Oncology (2015) 26 (suppl_9): 156-160. 10.1093/annonc/mdv535

Authors

S. Gupta1, H. Kp1, S. Roy1, D. Sharma1, P.K. Julka2, G.K. Rath3

Author affiliations

  • 1 Radiotherapy And Oncology, All India Institute of Medical Sciences, 110029 - New Delhi/IN
  • 2 Department Of Radiotherapy And Oncology, B.R. Ambedkar Institute Rotary Cancer Hospital (AIMS), 110029 - New Delhi/IN
  • 3 Rotary Cancer Hospital,, B.R. Ambedkar Institute Rotary Cancer Hospital (AIMS), 110029 - New Delhi/IN
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Aim/Background

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.

Methods

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.

Results

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.

TOXICITY PRIMARY MALIGNANCIES
Hyponatremia lung: 2 Glioblastoma: 1 Seminoma: 2
Hypokalemia lung: 1 rectum: 1 Sarcoma: 1 cervix: 1
Hypercalcemia lung: 1 CUP with skeletal metastasis: 1
Hypomagnesaemia Seminoma: 1
Diabetic keto-acidosis breast: 1
Hyperkalemia esophagus: 1

Conclusions

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

Disclosure

All authors have declared no conflicts of interest.

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