| Title | Chemotherapy-Associated Toxicity in a Large Cohort of Elderly Patients with Non-small Cell Lung Cancer. | | Author(s) | Hardy D, Cormier JN, Xing Y, Liu CC, Xia R, Du XL | | Institution | *Division of Epidemiology, University of Texas School of Public Health; daggerDepartment of Surgical Oncology, University of Texas M. D. Anderson Cancer Center; and double daggerCenter for Health Services Research, University of Texas School of Public Health, Houston, Texas. | | Source | J Thorac Oncol 2009 Oct 30. | | Abstract | BACKGROUND:: The objective of this study was to examine the risks for short-term (</=3 months) and long-term (>3 months) chemotherapy-associated toxicities in a large population-based cohort of patients with non-small cell lung cancer from 1991 to 2002.
METHODS:: The population consisted of 41,361 men and 30,804 women >/=65 years identified from the Surveillance, Epidemiology, and End Results-Medicare-linked database. The incidence of 50 toxicity-associated end points was calculated for 14 chemotherapy agents. Short- and long-term toxicities with a >/=2-fold increase in incidence compared with the no-chemotherapy group were defined as chemotherapy-associated toxicities. Hazard ratios and 95% confidence intervals for the risk of toxicity were calculated for the four most common chemotherapy agents for non-small cell lung cancer: cisplatin/carboplatin, paclitaxel, vinorelbine/vinblastine, and gemcitabine.
RESULTS:: The most common short-term toxicities (9.2-60%) included acute anemia, nausea, and neutropenia. The most common long-term toxicities (15-37%) included acute anemia, respiratory failure, pulmonary fibrosis, dehydration, neutropenia, nausea, and fever. Multivariate analysis for selected chemotherapies demonstrated that after adjusting for other risk factors and confounders, some short-term toxicities became nonsignificant; however, almost all long-term toxicities remained significant. Long-term toxicity increased over time and was more likely in women, minority populations, those with fewer baseline comorbidities, and across disease stages.
CONCLUSIONS:: The administration of various chemotherapy agents for non-small cell lung was associated with a number of short- and long-term toxicities. The projected survival benefits of chemotherapy must be weighed against the risk of long-term toxicities. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19884853 |
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