Chemotherapy-associated toxicity in a large cohort of elderly patients with non-small cell lung cancer

Dale Hardy, Janice N. Cormier, Yan Xing, Chih Chin Liu, Rui Xia, Xianglin L. Du

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND: The objective of this study was to examine the risks for short-term (< or =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 > or =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 > or =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.

Original languageEnglish (US)
Pages (from-to)90-98
Number of pages9
JournalJournal of Thoracic Oncology
Volume5
Issue number1
DOIs
StatePublished - Jan 1 2010

Fingerprint

Non-Small Cell Lung Carcinoma
Drug Therapy
gemcitabine
Neutropenia
Nausea
Anemia
Population
Vinblastine
Pulmonary Fibrosis
Carboplatin
Incidence
Medicare
Dehydration
Respiratory Insufficiency
Comorbidity
Epidemiology
Fever
Multivariate Analysis
Databases
Confidence Intervals

Keywords

  • Chemotherapy
  • Comorbidities
  • Non-small cell lung cancer
  • Toxicity
  • Tumor stage
  • Years of diagnosis

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Chemotherapy-associated toxicity in a large cohort of elderly patients with non-small cell lung cancer. / Hardy, Dale; Cormier, Janice N.; Xing, Yan; Liu, Chih Chin; Xia, Rui; Du, Xianglin L.

In: Journal of Thoracic Oncology, Vol. 5, No. 1, 01.01.2010, p. 90-98.

Research output: Contribution to journalArticle

Hardy, Dale ; Cormier, Janice N. ; Xing, Yan ; Liu, Chih Chin ; Xia, Rui ; Du, Xianglin L. / Chemotherapy-associated toxicity in a large cohort of elderly patients with non-small cell lung cancer. In: Journal of Thoracic Oncology. 2010 ; Vol. 5, No. 1. pp. 90-98.
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AU - Hardy, Dale

AU - Cormier, Janice N.

AU - Xing, Yan

AU - Liu, Chih Chin

AU - Xia, Rui

AU - Du, Xianglin L.

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N2 - BACKGROUND: The objective of this study was to examine the risks for short-term (< or =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 > or =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 > or =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.

AB - BACKGROUND: The objective of this study was to examine the risks for short-term (< or =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 > or =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 > or =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.

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