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Evaluation of early fluoropyrimidine toxicity in solid organ cancer patients: a retrospective observational study in Australia.
- Source :
-
Internal medicine journal [Intern Med J] 2024 Sep; Vol. 54 (9), pp. 1506-1514. Date of Electronic Publication: 2024 Jul 04. - Publication Year :
- 2024
-
Abstract
- Background: Despite common global usage, fluoropyrimidine (FP; 5-flurouracil and capecitabine)-related chemotherapy toxicity is poorly reported in the literature, with serious toxicity ranging from 10% to 40% and early toxicity (within 60 days of exposure) quoted at 14%. Data reflecting the incidence of Grades 3-5 FP-related toxicity in Australian cancer patients is scant, despite the significant impact of toxicity on patients (hospitalisations, intensive care unit (ICU) admissions and even death).<br />Aims: This retrospective audit evaluated Grades 3-5 toxicities in a contemporaneous cohort of 500 patients receiving FP chemotherapies within the Hunter-New England Local Health District from June 2020 to June 2022. Data were extracted from public hospital records and oncology-specific e-records to determine rates of toxicity and associated hospitalisations, intensive care admissions and deaths that occurred within 60 days of first exposure to FP chemotherapy-containing regimens.<br />Results: One hundred and fifty incidents of Grades 3-4 toxicity in the first 60 days led to 87 patients presenting to hospital (87/500, 17.4%). The most common serious toxicities were diarrhoea (39.3%), nausea and vomiting (22.7%) and febrile neutropaenia (10%). Four patients were admitted to the ICU, and four patients died of toxicity. Within the first 60 days, 22.2% of patients required treatment delays, 21.4% required dose reductions, and 7.8% of patients ceased treatment because of toxicities.<br />Discussion and Conclusion: Our experience reflects international reports and is likely generalisable to the Australian population. These data are a basis to understand the potential benefits of precision medicine strategies such as pharmacogenomic screening to improve patient tolerability and the cost-effectiveness of FP chemotherapy prescribing.<br /> (© 2024 Royal Australasian College of Physicians.)
- Subjects :
- Humans
Retrospective Studies
Male
Female
Middle Aged
Aged
Australia epidemiology
Adult
Hospitalization statistics & numerical data
Antimetabolites, Antineoplastic adverse effects
Aged, 80 and over
Diarrhea chemically induced
Diarrhea epidemiology
Capecitabine adverse effects
Fluorouracil adverse effects
Fluorouracil therapeutic use
Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1445-5994
- Volume :
- 54
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Internal medicine journal
- Publication Type :
- Academic Journal
- Accession number :
- 38963005
- Full Text :
- https://doi.org/10.1111/imj.16463