Hospitalization Risk Depended on Type of Chemotherapy Used

Hospitalization risk associated with common early stage breast cancer treatments identified

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Chemotherapy for breast cancer comes with a long list of possible risks, including hospitalization, but not all chemotherapy regimens carry the same risk.

A recent study showed that different combinations of chemotherapy medications used to fight early-stage breast cancer came with different levels of risk for hospitalization.

The study also revealed that age played a role in which chemotherapy treatment had the highest and lowest risk of hospitalization.

"Discuss chemotherapy options with your oncologist."

This study was led by Carlos Barcenas, MD, assistant professor of Breast Medical Oncology at The University of Texas MD Anderson Cancer Center in Houston, TX.

The research team looked at data from the Surveillance, Epidemiology and End Results (SEER) registry, compiled by the National Cancer Institute, Marketscan and the Texas Cancer Registry.

Dr. Barcenas and team identified 3,567 patients age 65 or older and 9,327 patients under the age of 65 who were treated for early-stage breast cancer between 2003 and 2007.

The researchers assessed patients' risk of being hospitalized within six months of receiving one of six common chemotherapy treatments for breast cancer. Hospitalization could occur due to infection, fever, anemia, dehydration, neutropenia (low white blood cell count), thrombocytopenia (low blood platelets) and delirium.

“By characterizing subsets of patients at greatest risk for developing toxicities and adverse side-effects, clinicians may be able to select more tolerable treatments,” Dr. Barcenas said in a press release.

For women under the age of 65, the lowest hospitalization rate within six months of chemotherapy, according to this study, was 6.2 percent for patients on a treatment regimen of doxorubicin (Adriamycin, Doxil) and cyclophosphamide (Endoxan) cycled every two weeks, followed or preceded by paclitaxel (Abraxane, Onxol ) cycled every two weeks.

For women aged 65 and older, the lowest hospitalization rate within six months of chemotherapy was 12.7 percent for patients on a treatment regimen of docetaxel and cyclophosphamide cycled every three weeks.

The highest risk of hospitalization for all women occurred when patients were treated with docetaxel (Taxotere, Docefrez), doxorubicin and cyclophosphamide cycled every three weeks. Women under 65 had a 10 percent hospitalization rate on this treatment, while the rate for women 65 and older was 24.2 percent.

One possible limitation of this study was that hospitalization data can under-represent the amount of people with chemotherapy-related events because milder events are often treated in outpatient settings.

This study was published May 27 in the Journal of Clinical Oncology.

This study was funded in part by the Center for Comparative Effectiveness Research on Cancer in Texas and the National Institutes of Health through MD Anderson’s Cancer Center.

The authors made no disclosures.

Review Date: 
May 29, 2014
Last Updated:
May 31, 2014