2985 - Clinical utility of a systematic toxicity assessment form (STAF) in patients with breast cancer receiving adjuvant or neoadjuvant therapy.

Background

Proper evaluation and management of chemotherapy-related toxicity (CRT) is critical to cancer patients. We aimed to assess the clinical utility of STAF in patients with breast cancer receiving chemotherapy.

Methods

The STAF is a systematic form including common CRT lists and grades to help clinicians to assess CRT comprehensively as opposed to assessing CRT individually by cases. Using data from clinical data warehouse, the CRT profile was analyzed in patients with breast cancer receiving adjuvant or neoadjuvant therapy during two time periods; before (n = 1874) and after (n = 981) using STAF in the clinic at Asan Medical Center. The two cohorts were matched by age and chemotherapy, leaving conventional practice (A; n = 333) and STAF (B; n = 333) groups. The rates of unscheduled hospital utilization (outpatient department [OPD], emergency room [ER] and hospitalization) were compared between group A and B.

Results

No significant differences were noted in baseline characteristics between the two groups, except for a higher proportion of patients living near the hospital in group A compared to group B (67.0 vs 56.2%; P = 0.004). The completion rate of planned chemotherapy was 96.7% and 97.6% (P = 0.704), and the rate of dose reduction was 12.3% and 10.8% (P = 0.473), respectively, in group A and B. The median dose intensity was lower in group A than group B (0.92 vs. 0.95; P < 0.001). Higher reporting of CRT was observed in group B (P < 0.001). Despite a similar rate of unscheduled hospital utilization during cycle 1, since cycle 2, group B had a lower frequency of unexpected OPD (3.3 vs 6.6%, P = 0.050) and ER visits (9.6 vs 16.8%, P = 0.006), and hospitalization (8.4 vs 12.6%; P = 0.077) than group A.Table:

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Conclusions

Using the STAF may facilitate to capture CRT in clinical practice and reduce the rates of unscheduled hospital utilization in patients with breast cancer receiving adjuvant or neoadjuvant therapy.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Korean Foundation for Cancer Research.

Disclosure

All authors have declared no conflicts of interest.