Which Chemotherapy Regimens Are Likely to Cause Hospitalization?

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Chemotherapy uses medicines to weaken and destroy cancer cells in the body, including cells at the original cancer site and any cancer cells that may have spread to another part of the body. Chemotherapy is systemic therapy, which means it affects the whole body by going through the bloodstream.

Chemotherapy destroys cancer cells because the medicines target rapidly dividing cells. But normal cells in your blood, mouth, intestinal tract, nose, nails, vagina, and hair also divide rapidly. So chemotherapy affects them, too, causing side effects that can range from mild to severe depending on the regimen you’re on, the length of treatment, and your general health.

A new study looked at the risk of hospitalization for side effects caused by six chemotherapy regimens commonly used to treat women diagnosed with early-stage breast cancer. It found that two regimens, both containing Taxotere (chemical name: docetaxel) and Adriamycin (chemical name: doxorubicin), were linked to the highest risk of hospitalization in women younger than 65.

The research was published online on May 27, 2014 by the Journal of Clinical Oncology. Read the abstract of “Risk of Hospitalization According to Chemotherapy Regimen in Early-Stage Breast Cancer.”

The researchers looked at the records of 3,567 women aged 65 and older who were diagnosed with early-stage breast cancer. These anonymous records came from the National Cancer Institute SEER registry and the Texas Cancer registry. The researchers also looked at the records of 9,327 women younger than 65 who were diagnosed with early-stage breast cancer. These anonymous records came from Marketscan, a national employment claims database.

The women were put into six groups depending on the chemotherapy regimen they were treated with:

  • Taxotere and Cytoxan (chemical name: cyclophosphamide) cycled every 3 weeks, abbreviated TC (1,060 women younger than 65 and 597 women 65 and older)
  • Adriamycin and Cytoxan cycled every 3 weeks, abbreviated AC (2,889 women younger than 65 and 1,407 women 65 and older)
  • Taxotere, Adriamycin, and Cytoxan cycled every 3 weeks, abbreviated TAC (1,516 women younger than 65 and 240 women 65 and older)
  • Adriamycin and Cytoxan cycled every 3 weeks followed or preceded by Taxotere every 3 weeks, abbreviated AC+T (894 women younger than 65 and 629 women 65 and older)
  • Adriamycin and Cytoxan cycled every 2 weeks followed or preceded by Taxol (chemical name: paclitaxel) every 2 weeks, abbreviated ddAC+P (2,657 women younger than 65 and 477 women 65 and older)
  • Adriamycin and Cytoxan cycled every 3 weeks followed or preceded by weekly Taxol, abbreviated AC+wP (311 women younger than 65 and 217 women 65 and older)

The researchers then looked to see how many women were admitted to the hospital for reasons related to chemotherapy within 6 months of starting chemotherapy. Reasons for hospitalization included:

  • infection
  • fever
  • anemia
  • dehydration
  • low white blood cell count
  • low platelet count
  • delirium

For women younger than 65, hospitalization rates by regimen were:

  • TC: 6.8%
  • AC: 6.5%
  • TAC: 10.0%
  • AC+T: 8.7%
  • ddAC+P: 6.2%
  • AC+wP: 9.0%

For women 65 and older, hospitalization rates by regimen were:

  • TC: 12.7%
  • AC: 17.5%
  • TAC: 24.2%
  • AC+T: 19.4%
  • ddAC+P: 16.4%
  • AC+wP: 23.0%

So in women younger than 65, the TAC and AC+T regimens were linked to the highest risk of being hospitalized. In women 65 and older, all the regimens except for ddAC+P were associated with a higher risk of hospitalization compared to the TC regimen.

If you’re deciding on chemotherapy after surgery for early-stage breast cancer, talk to your doctor about the risks and benefits of each regimen you’re considering, as well as your personal risk of serious side effects from each regimen. If you’re currently getting chemotherapy and are having side effects, it’s important to talk to your doctor. There are medicines you can take to control these side effects.

For more information on chemotherapy regimens and side effects, visit the Breastcancer.org Chemotherapy section.



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