Journal of Clinical Oncology, Vol 20, Issue 24
(December), 2002: 4636-4642
© 2002 American Society for Clinical Oncology
Population-Based Assessment of Hospitalizations for Toxicity From Chemotherapy in Older Women With Breast Cancer
By Xianglin L. Du,
Cynthia Osborne,
James S. Goodwin
From the Departments of Internal Medicine and Preventive Medicine and Community Health and Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX.
Address reprint requests to Xianglin L. Du, MD, PhD, Department of Internal Medicine, 3.134 Jennie Sealy Hospital, University of Texas Medical Branch, Galveston, TX 77555-0460; email: xdu{at}utmb.edu
PURPOSE: There are no population-based data on hospitalization rate for toxicity from breast cancer chemotherapy, and even large clinical trials often do not report this information. Medicare data, linked to the Surveillance, Epidemiology, and End-Results (SEER) tumor registries, are now used to assess rates of hospitalization for chemotherapy-related toxicity in a population-based setting.
PATIENTS AND METHODS: A total of 35,060 women diagnosed with stages I through IV breast cancer aged  65 from 1991 through 1996 were identified from the SEER-Medicare linked program and studied. Patients were defined as being hospitalized for adverse effects of chemotherapy if there was a Medicare inpatient claim for neutropenia, fever, thrombocytopenia, or adverse effect of systemic therapy less than 7 months after diagnosis of breast cancer.
RESULTS: More than 9% of women with breast cancer who received chemotherapy were admitted with the diagnosis of neutropenia, fever, thrombocytopenia, or adverse effect of systemic therapy, compared with 0.5% of women with breast cancer who did not receive chemotherapy. The rates for stage I to IV were 6.3%, 8.1%, 12.3%, and 13.2% in those treated with chemotherapy, and 0.4%, 0.6%, 0.7%, and 1.5% in women not treated with chemotherapy. The hospitalization rates for adverse effects increased significantly with comorbidity score and varied more than two-fold across the nine SEER areas but did not vary by age. Use of anthracycline-containing chemotherapy agents was associated with greater odds of these toxicities (eg, odds ratio, 2.53 for neutropenia; 95% confidence interval, 1.97 to 3.26).
CONCLUSION: This study demonstrated the feasibility of using Medicare data to assess rates of hospitalization for serious toxicity associated with cancer chemotherapy. Rates in actual practice were higher than those reported in clinical trials and did not vary by age.
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Facebook  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
T. P. Srokowski, S. Fang, G. N. Hortobagyi, and S. H. Giordano
Impact of Diabetes Mellitus on Complications and Outcomes of Adjuvant Chemotherapy in Older Patients With Breast Cancer
J. Clin. Oncol.,
May 1, 2009;
27(13):
2170 - 2176.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. L. Hershman, D. Buono, R. B. McBride, W. Y. Tsai, K. A. Joseph, V. R. Grann, and J. S. Jacobson
Surgeon Characteristics and Receipt of Adjuvant Radiotherapy in Women With Breast Cancer
J Natl Cancer Inst,
February 6, 2008;
100(3):
199 - 206.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. B. Muss, D. A. Berry, C. Cirrincione, D. R. Budman, I. C. Henderson, M. L. Citron, L. Norton, E. P. Winer, and C. A. Hudis
Toxicity of Older and Younger Patients Treated With Adjuvant Chemotherapy for Node-Positive Breast Cancer: The Cancer and Leukemia Group B Experience
J. Clin. Oncol.,
August 20, 2007;
25(24):
3699 - 3704.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. S. Wilkinson, Y.-F. Kuo, J. L. Freeman, and J. S. Goodwin
Intravenous Bisphosphonate Therapy and Inflammatory Conditions or Surgery of the Jaw: A Population-Based Analysis
J Natl Cancer Inst,
July 4, 2007;
99(13):
1016 - 1024.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Hershman, A. I. Neugut, J. S. Jacobson, J. Wang, W.-Y. Tsai, R. McBride, C. L. Bennett, and V. R. Grann
Acute Myeloid Leukemia or Myelodysplastic Syndrome Following Use of Granulocyte Colony-Stimulating Factors During Breast Cancer Adjuvant Chemotherapy
J Natl Cancer Inst,
February 7, 2007;
99(3):
196 - 205.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. J. Hassett, A. J. O'Malley, J. R. Pakes, J. P. Newhouse, and C. C. Earle
Frequency and cost of chemotherapy-related serious adverse effects in a population sample of women with breast cancer.
J Natl Cancer Inst,
August 16, 2006;
98(16):
1108 - 1117.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. H. Giordano, Z. Duan, Y.-F. Kuo, G. N. Hortobagyi, and J. S. Goodwin
Use and Outcomes of Adjuvant Chemotherapy in Older Women With Breast Cancer
J. Clin. Oncol.,
June 20, 2006;
24(18):
2750 - 2756.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. L.B. Miller, L. E. Jones, and C. P. Carney
Psychiatric Sequelae Following Breast Cancer Chemotherapy: A Pilot Study Using Claims Data
Psychosomatics,
December 1, 2005;
46(6):
517 - 522.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. J. Doyle, A. I. Neugut, J. S. Jacobson, V. R. Grann, and D. L. Hershman
Chemotherapy and Cardiotoxicity in Older Breast Cancer Patients: A Population-Based Study
J. Clin. Oncol.,
December 1, 2005;
23(34):
8597 - 8605.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
X. L. Du, D. R. Lairson, C. E. Begley, and S. Fang
Temporal and Geographic Variation in the Use of Hematopoietic Growth Factors in Older Women Receiving Breast Cancer Chemotherapy: Findings From a Large Population-Based Cohort
J. Clin. Oncol.,
December 1, 2005;
23(34):
8620 - 8628.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
X. L. Du, D. V. Jones, and D. Zhang
Effectiveness of Adjuvant Chemotherapy for Node-Positive Operable Breast Cancer in Older Women
J Gerontol A Biol Sci Med Sci,
September 1, 2005;
60(9):
1137 - 1144.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Brunello, U. Basso, C. Pogliani, A. Jirillo, C. Ghiotto, H. Koussis, F. Lumachi, M. Iacobone, L. Vamvakas, and S. Monfardini
Adjuvant chemotherapy for elderly patients (>=70 years) with early high-risk breast cancer: a retrospective analysis of 260 patients
Ann. Onc.,
August 1, 2005;
16(8):
1276 - 1282.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. B. Lamont, J. E. Herndon II, J. C. Weeks, I. C. Henderson, R. Lilenbaum, R. L. Schilsky, N. A. Christakis, and for the Cancer and Leukemia Group B
Criterion Validity of Medicare Chemotherapy Claims in Cancer and Leukemia Group B Breast and Lung Cancer Trial Participants
J Natl Cancer Inst,
July 20, 2005;
97(14):
1080 - 1083.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Sassi, B. Striano, and U. A Merlo
A reporting system for the assessment of chemotherapy toxicity
Journal of Oncology Pharmacy Practice,
June 1, 2005;
11(2):
63 - 67.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. K. Krzyzanowska, J. Treacy, B. Maloney, A. Lavino, and J. O. Jacobson
Development of a Patient Registry to Evaluate Hospital Admissions Related to Chemotherapy Toxicity in a Community Cancer Center
J. Oncol. Pract,
May 1, 2005;
1(1):
15 - 19.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. B. Muss, S. Woolf, D. Berry, C. Cirrincione, R. B. Weiss, D. Budman, W. C. Wood, I. C. Henderson, C. Hudis, E. Winer, et al.
Adjuvant Chemotherapy in Older and Younger Women With Lymph Node-Positive Breast Cancer
JAMA,
March 2, 2005;
293(9):
1073 - 1081.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Watters, J. C. Yau, K. O'Rourke, E. Tomiak, and S. Z. Gertler
Functional status is well maintained in older women during adjuvant chemotherapy for breast cancer
Ann. Onc.,
December 1, 2003;
14(12):
1744 - 1750.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Monson, D. A. Litvak, and R. J. Bold
Surgery in the Aged Population: Surgical Oncology
Arch Surg,
October 1, 2003;
138(10):
1061 - 1067.
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. C. Harlan and B. F. Hankey
The Surveillance, Epidemiology, and End-Results Program Database as a Resource for Conducting Descriptive Epidemiologic and Clinical Studies
J. Clin. Oncol.,
June 15, 2003;
21(12):
2232 - 2233.
[Full Text]
[PDF]
|
|
|
|
|
|
|
X. L. Du, C. R. Key, C. Osborne, J. D. Mahnken, and J. S. Goodwin
Discrepancy between Consensus Recommendations and Actual Community Use of Adjuvant Chemotherapy in Women with Breast Cancer
Ann Intern Med,
January 21, 2003;
138(2):
90 - 97.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
