Jeong Jonghyun, Park Soyoung, Heo Kyu-Nam, Park Soh Mee, Min Sangil, Ah Young-Mi, Han Ji Min, Lee Ju-Yeun
College of Pharmacy, Seoul National University, Seoul, Republic of Korea.
Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Ther Adv Med Oncol. 2024 Aug 27;16:17588359241272970. doi: 10.1177/17588359241272970. eCollection 2024.
The rising global incidence of cancer has increased the demand for chemotherapy, which is a crucial treatment modality. Recent advancements in cancer treatment, including targeted agents and immunotherapy, have introduced complications owing to their specific mechanisms. However, comprehensive studies of the combined complications of these approaches are lacking.
This study aimed to comprehensively assess and analyze the overall incidence of anticancer drug-related complications in a nationwide patient cohort, utilizing a customized National Health Insurance Sharing Service database in Korea.
Retrospective cohort study.
We included patients who were prescribed anticancer drugs (excluding endocrine agents) and diagnosed with cancer. For the type of cancer classification, the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) was used and anticancer drugs were classified based on the Anatomical Therapeutic Chemical code. We classified cancer into 18 types based on the ICD-10 code and delineated cancer-related complications into 12 categories. Complications included hematological, gastrointestinal, infectious, cardiovascular, major bleeding, endocrine, neurotoxic, nephrotoxic, dermatological, pulmonary, musculoskeletal, and hepatotoxic effects.
We included 294,544 patients diagnosed with cancer and administered anticancer drugs between 2016 and 2018, with follow-up continuing until 2021. We identified 486,929 anticancer drug-related complications, with an incidence of 1843.6 per 1000 person-years (PY). Anemia was the most common complication, with a rate of 763.7 per 1000 PY, followed by febrile neutropenia (295.7) and nausea/vomiting (246.9). Several complications peaked during the first months following the initiation of anticancer drug therapy; however, herpes, skin infection, heart failure, and peripheral neuropathy peaked at 6-12 months. Among major cancers, breast cancer had the lowest overall incidence of complications. Targeted therapies revealed lower complication rates than cytotoxic chemotherapy; however, they also required careful monitoring of rash.
This study highlights the importance of the proactive management of anticancer drug-related complications for patient care improvement.
全球癌症发病率的上升增加了对化疗的需求，化疗是一种关键的治疗方式。癌症治疗的最新进展，包括靶向药物和免疫疗法，因其特定机制引发了并发症。然而，缺乏对这些方法合并并发症的全面研究。
本研究旨在利用韩国定制的国民健康保险共享服务数据库，全面评估和分析全国患者队列中抗癌药物相关并发症的总体发生率。
回顾性队列研究。
我们纳入了开具抗癌药物（不包括内分泌药物）并被诊断患有癌症的患者。对于癌症分类类型，使用国际疾病分类第十版（ICD - 10），并根据解剖治疗化学代码对抗癌药物进行分类。我们根据ICD - 10代码将癌症分为18种类型，并将癌症相关并发症分为12类。并发症包括血液学、胃肠道、感染性、心血管、大出血、内分泌、神经毒性、肾毒性、皮肤病学、肺部、肌肉骨骼和肝毒性作用。
我们纳入了2016年至2018年间诊断患有癌症并接受抗癌药物治疗的294,544名患者，随访持续至2021年。我们确定了486,929例抗癌药物相关并发症，发病率为每1000人年（PY）1843.6例。贫血是最常见的并发症，发生率为每1000 PY 763.7例，其次是发热性中性粒细胞减少（295.7）和恶心/呕吐（246.9）。几种并发症在抗癌药物治疗开始后的头几个月达到高峰；然而，疱疹、皮肤感染、心力衰竭和周围神经病变在6 - 12个月达到高峰。在主要癌症中，乳腺癌的总体并发症发生率最低。靶向治疗的并发症发生率低于细胞毒性化疗；然而，它们也需要仔细监测皮疹。
本研究强调了积极管理抗癌药物相关并发症以改善患者护理的重要性。
