Effect of Hospitalization During First Chemotherapy and Performance Status on Small-cell Lung Cancer Outcomes
Autor: | Oliver Bucher, Shantanu Banerji, David E. Dawe, Rebekah Rittberg, Susan Green, Trevor Aquin |
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Rok vydání: | 2020 |
Předmět: |
Male
0301 basic medicine Pulmonary and Respiratory Medicine Cancer Research medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Neutropenia Carboplatin Nephrotoxicity 03 medical and health sciences 0302 clinical medicine Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Progression-free survival Lung cancer Aged Etoposide Retrospective Studies Chemotherapy Performance status business.industry Retrospective cohort study Prognosis medicine.disease Small Cell Lung Carcinoma Hospitalization Survival Rate 030104 developmental biology Oncology 030220 oncology & carcinogenesis Cohort Female business Follow-Up Studies |
Zdroj: | Clinical Lung Cancer. 21:e388-e404 |
ISSN: | 1525-7304 |
Popis: | Small-cell lung cancer (SCLC) is highly responsive to chemotherapy (CT) and one of the few malignancies treated in hospitalized patients with poor Eastern Cooperative Oncology Group (ECOG) performance status (PS). Because of the little current information available on the outcomes experienced by hospitalized patients with SCLC receiving CT, we explored the outcomes for these patients to improve the evidence base for practice.We conducted a retrospective cohort study to evaluate patients with a diagnosis of SCLC and treated with CT during a 10-year period. Progression-free survival (PFS) and overall survival (OS) were evaluated according to site of first CT (inpatient vs. outpatient) and PS. Multivariable analysis was completed to assess for independent survival predictors.A total of 530 patients with SCLC were treated, with 82 (15%) receiving their first CT in hospital. Inpatients had a greater burden of disease and poorer PS. Neutropenia, thrombocytopenia, nephrotoxicity, and fatigue were all experienced less often by the inpatient cohort (P .001, P .001, P .001, and P = .007, respectively). For inpatients and outpatients, the OS rate at 12, 24, and 60 months was 22%, 9%, and 7% and 43%, 20%, and 9%, respectively (P .001 for all). The median PFS and OS were longer for outpatients and highly functional patients. On multivariable analysis, ECOG PS was an independent predictor of the outcome and the site of first CT was not (P = .04 and P = .49, respectively).Patients with SCLC initially treated as inpatients and those with poor functional status had shorter PFS and OS; however, some experienced long-term survival, including 5-year survival of 7% for the inpatient cohort and 5% for the ECOG PS 3-4 cohort. CT toxicities were less common in the inpatient cohort, validating that administration of CT in hospital should be considered for these patients because they could experience a meaningful long-term response to therapy. |
Databáze: | OpenAIRE |
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