Featured Research

from universities, journals, and other organizations

Risk of chemotherapy related hospitalization for eary-stage breast cancer patients

Date:
May 27, 2014
Source:
University of Texas M. D. Anderson Cancer Center
Summary:
Oncologists now have a new understanding of the toxicity levels of specific chemotherapy regimens used for women with early stage breast cancer, according to research. The retrospective study used large population-based data to compare the risk of hospitalization for six common chemotherapy regimens. Reasons for hospitalization included infection, fever, anemia, dehydration, neutropenia (low white blood cell count), thrombocytopenia (low blood platelets) and delirium.

Oncologists now have a new understanding of the toxicity levels of specific chemotherapy regimens used for women with early stage breast cancer, according to research from The University of Texas MD Anderson Cancer Center.

The retrospective study, published in the Journal of Clinical Oncology, used large population-based data to compare the risk of hospitalization for six common chemotherapy regimens. Reasons for hospitalization included infection, fever, anemia, dehydration, neutropenia (low white blood cell count), thrombocytopenia (low blood platelets) and delirium.

"The novelty of our study is that we were able to identify and delineate between different chemotherapy regimens in early-stage breast cancer using claims data, considered as real-world and non-clinical trial information," said Carlos Barcenas, M.D., assistant professor, Breast Medical Oncology and corresponding author.

There have been several prior publications in the health services research field addressing chemotherapy toxicity using claims data, but they don't outline specific chemotherapy regimens, Barcenas explained.

"The difficulty in the methodology is that most of these regimens are composed of several agents and have specific cycling times. The chemotherapy regimens have usually been referred to as "anthracycline" or "taxane-based," Barcenas said. "By characterizing subsets of patients at greatest risk for developing toxicities and adverse side-effects, clinicians may be able to select more tolerable treatments."

Researchers combined data from the Surveillance, Epidemiology and End Results (SEER) registry, compiled by the National Cancer Institute, and the Texas Cancer Registry to identify 3,567 patients ages 65 and older being treated for early stage breast cancer between 2003 and 2007. Additional data from Marketscan, a nation-wide employment claims database, identified 9,327 patients younger than 65 years of age with early stage disease.

Patients were then categorized into groups according to the chemotherapy regimens they received including:

• Docetaxel and cyclophosphamide cycled every three weeks (TC)

• Doxorubicin and cyclophosphamide cycled every three weeks (AC)

• Docetaxel, doxorubicin and cyclophosphamide cycled every three weeks (TAC)

• Doxorubicin and cyclophosphamide cycled every three weeks, followed or preceded by docetaxel cycled every three weeks (AC+T)

• Doxorubicin and cyclophosphamide cycled every two weeks, followed or preceded by paclitaxel cycled every two weeks (ddAC+P)

• Doxorubicin and cyclophosphamide cycled every three weeks followed or preceded by weekly paclitaxel (AC+wP)

Among patients younger than 65 years of age, the hospitalization rates ranged from 6.2 percent (ddAC+P) to 10 percent (TAC). In patients older than 65, rates ranged from 12.7 percent (TC) to 24.2 percent (TAC).

"Our findings demonstrate that TAC and AC+T were associated with the highest risk of hospitalization in patients younger than age 65," Barcenas said. "And for older patients all regimens, aside from ddAC+P, were associated with a higher risk of hospitalization compared to the regimen TC."

Barcenas notes these findings need to be taken with the consideration of potential biases where less aggressive regimens may have been offered to patients who are frailer.

Additionally, Barcenas said that findings showed that the use of the regimen TC has significantly increased over time, without any current evidence from clinical trials that this regimen is non-inferior to antracycline and taxane-based chemotherapy regimens.

The authors note several limitations exist with retrospective claims data research, including the inability to adjust for other clinical factors such as co-morbidities and therapy responses. Also, hospitalization data often underrepresents chemotherapy toxicities as mild events are usually managed in the outpatient setting.

Additional research is necessary to validate the study methodology. The most important question is which of these treatments is most effective for patients. It is likely that many of these regimens are similar in effectiveness and this study will help guide treatment by allowing physicians to pick the least toxic therapies, Barcenas said.


Story Source:

The above story is based on materials provided by University of Texas M. D. Anderson Cancer Center. Note: Materials may be edited for content and length.


Journal Reference:

  1. C. H. Barcenas, J. Niu, N. Zhang, Y. Zhang, T. A. Buchholz, L. S. Elting, G. N. Hortobagyi, B. D. Smith, S. H. Giordano. Risk of Hospitalization According to Chemotherapy Regimen in Early-Stage Breast Cancer. Journal of Clinical Oncology, 2014; DOI: 10.1200/JCO.2013.49.3676

Cite This Page:

University of Texas M. D. Anderson Cancer Center. "Risk of chemotherapy related hospitalization for eary-stage breast cancer patients." ScienceDaily. ScienceDaily, 27 May 2014. <www.sciencedaily.com/releases/2014/05/140527161720.htm>.
University of Texas M. D. Anderson Cancer Center. (2014, May 27). Risk of chemotherapy related hospitalization for eary-stage breast cancer patients. ScienceDaily. Retrieved August 1, 2014 from www.sciencedaily.com/releases/2014/05/140527161720.htm
University of Texas M. D. Anderson Cancer Center. "Risk of chemotherapy related hospitalization for eary-stage breast cancer patients." ScienceDaily. www.sciencedaily.com/releases/2014/05/140527161720.htm (accessed August 1, 2014).

Share This




More Health & Medicine News

Friday, August 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

House Republicans Vote to Sue Obama Over Healthcare Law

House Republicans Vote to Sue Obama Over Healthcare Law

Reuters - US Online Video (July 31, 2014) The Republican-led House of Representatives votes to sue President Obama, accusing him of overstepping his executive authority in making changes to the Affordable Care Act. Mana Rabiee reports. Video provided by Reuters
Powered by NewsLook.com
Despite Health Questions, E-Cigs Are Beneficial: Study

Despite Health Questions, E-Cigs Are Beneficial: Study

Newsy (July 31, 2014) Citing 81 previous studies, new research out of London suggests the benefits of smoking e-cigarettes instead of regular ones outweighs the risks. Video provided by Newsy
Powered by NewsLook.com
Dangerous Bacteria Kills One in Florida

Dangerous Bacteria Kills One in Florida

AP (July 31, 2014) Sarasota County, Florida health officials have issued a warning against eating raw oysters and exposing open wounds to coastal and inland waters after a dangerous bacteria killed one person and made another sick. (July 31) Video provided by AP
Powered by NewsLook.com
Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins