ER Visits for Toxicity Common in Women Receiving Adjuvant Chemotherapy for Breast Cancer: Presented at SABCS
By Jill Stein
SAN ANTONIO -- December 13, 2011 -- Nearly half of women with early breast cancer develop at least 1 serious toxicity resulting in an emergency room (ER) visit while they are undergoing adjuvant chemotherapy, according to a study presented December 9 at the 34th Annual San Antonio Breast Cancer Symposium (SABCS).
Katherine A Enright, MD, Peel Regional Cancer Centre, Mississauga, Ontario, and colleagues examined the frequency of serious treatment-related toxicity in 3,090 women identified from the Ontario Cancer Registry who had received at least 1 cycle of adjuvant chemotherapy for early breast cancer.
In clinical trial populations, serious adverse events resulting in hospitalisation from adjuvant chemotherapy are uncommon. Information regarding the frequency of serious chemotherapy-associated toxicities resulting in emergency visits or hospitalisation in the general population is also limited.
The women included in the current analysis had been diagnosed with early breast cancer during a recent 2-year period. They had also undergone curative breast surgery sometime between 2 weeks before their diagnosis of breast cancer to 4 months after diagnosis and had started adjuvant chemotherapy within 4 months of diagnosis.
The study focused on serious toxicities resulting in ER visits or hospitalisation between the start date of chemotherapy and 30 days after the last dose of chemotherapy.
Overall, 47% of women undergoing adjuvant chemotherapy had at least 1 acute care visit during their adjuvant chemotherapy (30% had ER visits alone, and 17% required hospitalisation). Most acute care visits were attributable to chemotherapy toxicities.
Patients receiving docetaxel-containing regimens had a significantly higher rate of developing serious toxicity resulting in acute care visits and hospitalisation for toxicity or febrile neutropenia than doxorubicin-containing regimens.
Serious toxicity resulting in death within 30 days was uncommon (0.2%) and was not significantly different across chemotherapy regimens.
Dr. Enright said that the routine use of primary granulocyte colony-stimulating factor prophylaxis and the development of routine care models may reduce the frequency of acute care utilisation and thus improve patient care and decrease healthcare costs.
[Presentation title: A Population Level Assessment of Emergency Room Visits and Hospitalizations for Women Undergoing Adjuvant Chemotherapy for Early Breast Cancer. Abstract P5-18-02]
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