Chemotherapy-associated toxicity in a large cohort of elderly patients with non-small cell lung cancer

Dale Hardy, Janice N. Cormier, Yan Xing, Chih Chin Liu, Rui Xia, Xianglin L. Du

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


BACKGROUND: The objective of this study was to examine the risks for short-term (< or =3 months) and long-term (>3 months) chemotherapy-associated toxicities in a large population-based cohort of patients with non-small cell lung cancer from 1991 to 2002. METHODS: The population consisted of 41,361 men and 30,804 women > or =65 years identified from the Surveillance, Epidemiology, and End Results-Medicare-linked database. The incidence of 50 toxicity-associated end points was calculated for 14 chemotherapy agents. Short- and long-term toxicities with a > or =2-fold increase in incidence compared with the no-chemotherapy group were defined as chemotherapy-associated toxicities. Hazard ratios and 95% confidence intervals for the risk of toxicity were calculated for the four most common chemotherapy agents for non-small cell lung cancer: cisplatin/carboplatin, paclitaxel, vinorelbine/vinblastine, and gemcitabine. RESULTS: The most common short-term toxicities (9.2-60%) included acute anemia, nausea, and neutropenia. The most common long-term toxicities (15-37%) included acute anemia, respiratory failure, pulmonary fibrosis, dehydration, neutropenia, nausea, and fever. Multivariate analysis for selected chemotherapies demonstrated that after adjusting for other risk factors and confounders, some short-term toxicities became nonsignificant; however, almost all long-term toxicities remained significant. Long-term toxicity increased over time and was more likely in women, minority populations, those with fewer baseline comorbidities, and across disease stages. CONCLUSIONS: The administration of various chemotherapy agents for non-small cell lung was associated with a number of short- and long-term toxicities. The projected survival benefits of chemotherapy must be weighed against the risk of long-term toxicities.

Original languageEnglish (US)
Pages (from-to)90-98
Number of pages9
JournalJournal of Thoracic Oncology
Issue number1
StatePublished - Jan 1 2010


  • Chemotherapy
  • Comorbidities
  • Non-small cell lung cancer
  • Toxicity
  • Tumor stage
  • Years of diagnosis

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine


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