Chemotherapy toxicity in advanced non-small cell lung cancer and its impact on survival

Introduction: Cytotoxic chemotherapy is widely used to palliate advanced non-small-cell lung cancer (NSCLC) but can induce severe toxic events. The aim of this study was to evaluate the chemotherapy toxicity in adavanced non-small cell lung cancer (NSCLC) and its impact on overall survival (OS). Methods: We retrospectively reviewed 99 advanced stage NSCLC patients treated with chemotherapy over a period of 3 years. Pre-therapeutic clinical and biological data were assessed. OS was calculated using the Kaplan Meier method and compared between two groups (having or not toxicity) by log rank test. Results: Median age was 65 years, 84% of patients had Performans status (PS) <2, 28% were malnourished (BMI <20 kg/m2). Anemia (Hb<12g/dL) and hypoalbuminemia were observed respectively in 30% and 10% of cases. Platinum chemotherapy regimen was used in 86% of cases. Seventy-eight percent of the patients has developed at least one chemotherapy related toxic event. Main toxicities were hematologic (47%; 26% of toxicity≥ grade 3), gastrointestinal (30%; 58% of toxicity ≥ grade 3) and renal (20%; 9% of toxicity ≥ grade 3). Eighty-five percent of toxic events occurred at the first line and on average over 1.7 th cycle. No toxic death event has happened. Patients with PS ≤2, anemia, malnutrition and hypoalbuminemia didn9t developed more chemotherapy-induced toxicity (p=0.66; p =0.48; p=0.93; p=0.78 respectively). OS of patients with chemotherapy toxic event was 12.3 months compared with 7.51 months in patients without chemotherapy toxic event (logrank; p = 0.002). Conclusion: Our study suggested that Chemotherapy-induced toxicity in advanced NSCLC patients was associated with poor survival.