Chemotherapy Induced Adverse Drug Reactions in Cancer Patients in a Tertiary Care Hospital in South India

Behera, Sapan Kumar; Kishtapati, Chenchu Reddy; Gunaseelan, Vikneswaran; Dubashi, Biswajit; Adithan, C; Selvarajan, Sandhiya

doi:10.5530/jyp.2017.9.113

Cited by 9 publications

(9 citation statements)

References 4 publications

(6 reference statements)

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“…Our finding is similar to the study carried out by Sharma et al [5] that showed adverse effects in the 41-60 years age group. This finding is also similar to the report of Pai et al [6] who also reported average age of subjects 55.98 years and 52.96 years in men and women respectively and likewise, a study of Behera et al [7] which showed adverse reactions in 41-60 years age group was highest. This can be because of the high occurrence of cancers in this particular age group.…”

Section: Discussionsupporting

confidence: 91%

A Clinical Study of Cutaneous Manifestations in Patients on Cancer Therapy at a Tertiary Care Hospital

Muralidhar¹,

Raghupathy²,

Sudha³

et al. 2020

jemds

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A B S T R A C T BACKGROUNDThe aim of cancer treatment is to target and destroy cancer cells. Adversely it affects rapidly dividing cells of bone marrow, hair, nails, skin and gastrointestinal mucosa. Drug induced side effects are seen in 25% of hospitalized cancer patients resulting in a variety of cutaneous adverse effects. This study analyses the cutaneous manifestations in patients on cancer therapy at a tertiary care hospital. METHODSThis is a hospital based observational study, done over a period of 2 years (September 2016 -September 2018), on cancer patients undergoing chemo or radiotherapy having cutaneous manifestations, referred to the Dermatology OPD from Oncology OPD in a tertiary hospital. RESULTSAmong 106 cases, 47% were males and 53% were females. Majority of patients belonged to the age group of 41-60 years (40%). Carcinoma of breast (13%) and lung (9%) presented in highest frequency. Out of 59 patients who were treated with chemotherapy alone, most common was anagen effluvium (59%) and least common were ichthyosis, erythema multiforme and herpes zoster (each 2%). Among 5 patients who were treated with radiation therapy alone, most common was radiation dermatitis and seborrheic dermatitis (each 40 %). Among 18 patients who underwent combined chemo and radiotherapy, most common was anagen effluvium (39%) and least was folliculitis, lichenoid dermatitis (each 7%). Among 8 patients who underwent surgery followed by adjuvant chemotherapy, most common was anagen effluvium (40%) and least was surgical site infection, eczema, folliculitis (each 12%). Among 16 patients who underwent combined chemo, radiation and surgery, most common was anagen effluvium (25%) and least common was surgical site infection (6%). 14% fungal, 10% bacterial and 6% viral infections were noted. Among 101 patients who received at least 1 chemotherapeutic agent, most commonly used agent was cisplatin (50%) and least commonly used agent was gemcitabine (3%). CONCLUSIONSEarly identification of adverse effects might help us to give a better quality of life and reduce psychosomatic distress of the patients. It might also assist in tailoring the therapy accordingly.

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Section: Discussionsupporting

confidence: 91%

A Clinical Study of Cutaneous Manifestations in Patients on Cancer Therapy at a Tertiary Care Hospital

Muralidhar¹,

Raghupathy²,

Sudha³

et al. 2020

jemds

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“…In general, the main goal of breast cancer chemotherapy is to increase disease-free survival and overall survival of the patients [1,2] though it causes diverse aspects of adverse drug reactions [3,4] that will deteriorate different domains of the patients' quality of life [19]. On the contrary, receiving less than optimum RDI (i.e., RDI < 85%) resulted in lower survival for those patients [29,31,47,55].…”

Section: Discussionmentioning

confidence: 99%

Patterns of Anthracycline-Based Chemotherapy-Induced Adverse Drug Reactions and Their Impact on Relative Dose Intensity among Women with Breast Cancer in Ethiopia: A Prospective Observational Study

Alemayehu

Assefa

Tefera

et al. 2020

Journal of Oncology

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Background. e breast cancer chemotherapy leads to diverse aspects of noxious or unintended adverse drug reactions (ADRs) that cause the relative dose intensity (RDI) reduced to below optimal (i.e., if the percentage of actual dose received per unit time divided by planned dose per unit time is less than 85%). Hence, this prospective observational study was conducted to evaluate chemotherapy-induced ADRs and their impact on relative dose intensity among women with breast cancer in Ethiopia.Methods. e study was conducted with a cohort of 146 patients from January 1 to September 30, 2017, Gregorian Calendar (GC) at the only nationwide oncology center, Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. e ADRs of the chemotherapy were collected using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) (version 4.03). e patients were personally interviewed for subjective toxicities, and laboratory results and supportive measures were recorded at each cycle. SPSS version 22 was used for analysis. Results. Grade 3 neutropenia (23 (15.8%)) was the most frequently reported ADR among grade 3 hematological toxicity on cycle 4. However, overall grade fatigue (136 (93.2%)) and grade 3 nausea (31 (21.2%)) were the most frequently reported nonhematological toxicities on cycle 1. e majority of ADRs were reported during the first four cycles except for peripheral neuropathy. Oral antibiotics and G-CSF use (17 (11.6%)) and treatment delay (31 (21.2%)) were frequently reported on cycle 3. Overall, 61 (41.8%) and 42 (28.8%) of study participants experienced dose delay and used G-CSF, respectively, at least once during their enrollment. Of the 933 interventions observed, 95 (10%) cycles were delayed due to toxicities in which neutropenia attributed to the delay of 89 cycles. Forty-four (30.1%) of the patients received overall RDI < 85%. Pretreatment hematological counts were significant predictors (P < 0.05) for the incidence of first cycle hematological toxicities such as neutropenia, anemia, and leukopenia and nonhematological toxicities like vomiting. Conclusion. Ethiopian women with breast cancer on anthracycline-based AC and AC-T chemotherapy predominantly experienced grade 1 to 3 hematological and nonhematological ADRs, particularly during the first four cycles. Neutropenia was the only toxicity that led to RDI < 85%. us, enhancing the utilization of G-CSF and other supportive measures will improve RDI to above 85%.

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“…Behera et al 8 conducted a study in a tertiary care hospital in India, claiming that 21.8% of ADRs were due to antineoplastic agents. However, in present research work, patients were observed with significant doubtful, probable, and possible ADRs.…”

Section: Discussionmentioning

confidence: 99%

Parallel Assessment of Chemotherapy Adherence and Supportive Therapy Adherence on Occurrence and Minimization of Adverse Drug Reactions Among Cancer Patients: A Clinical-Based Observational Study

Kumar

Gudhoor

Ganachari

2020

Journal of Pharmacy Technology

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Background: Cancer is a disease that is inevitably treated using chemotherapy, but the cytotoxic drugs used in the treatment have the potency to cause adverse drug reactions (ADRs). Thus, supportive therapy plays an essential role in managing the untoward effects of the cancer drugs in patients. This highlights the importance of medication adherence in managing the disease, mitigating and preventing the occurrence of chemotherapy-induced ADR without compromising the health status of the cancer population. Objective: To assess the adherence to chemotherapy and supportive therapy and to evaluate type and degree of causality of ADRs observed in cancer patients. Methods: On ethics committee approval, a 6-month observational study was conducted among recruited cancer patients undergoing chemotherapy in a tertiary care hospital. Morisky Medication Adherence Measurement Scale–8 was employed to assess the medication adherence, and ADR causality was determined using Naranjo ADR Probability Scale. Results: Ninety cancer patients participated in the study, out of which females were 61.11%. Chemotherapy adherence in comparison to supportive drugs was observed to be more (21.11%). Twelve different combination of ADR were reported in the subjects with variability in the degree of causality assessment. Conclusion and Relevance: The distinction of adherence to the medication used in cancer management with marked level of ADR was well depicted in the study, implicating the necessity of prudent symbiotic practice of an oncology pharmacist, patient, and physician relationship in optimizing the quality of life of cancer patients by imparting vigilant efforts in medication adherence.

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Chemotherapy Induced Adverse Drug Reactions in Cancer Patients in a Tertiary Care Hospital in South India

Cited by 9 publications

References 4 publications

A Clinical Study of Cutaneous Manifestations in Patients on Cancer Therapy at a Tertiary Care Hospital

A Clinical Study of Cutaneous Manifestations in Patients on Cancer Therapy at a Tertiary Care Hospital

Patterns of Anthracycline-Based Chemotherapy-Induced Adverse Drug Reactions and Their Impact on Relative Dose Intensity among Women with Breast Cancer in Ethiopia: A Prospective Observational Study

Parallel Assessment of Chemotherapy Adherence and Supportive Therapy Adherence on Occurrence and Minimization of Adverse Drug Reactions Among Cancer Patients: A Clinical-Based Observational Study

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