A reporting system for the assessment of chemotherapy toxicity

Abstract

Purpose: Toxicity may distress patients and cause delay or a discontinuance of scheduled chemotherapies. A key issue is to create a reporting system in order to assess toxicities and also evaluate treatments.

Methods: In the Oncology Unit 3,000 intravenous chemotherapies are administered each year, mostly in the day hospital. In summer 2002, oncologists and pharmacists agreed to assess myelosuppression and gastrointestinal toxicity of grades 3 and 4. Pharmacists designed a form and a database in order to collect toxicity data for every patient. The oncologist records type and grade of toxicity (according to the NCI CTC) on the patient chart before chemotherapy commences. During the validation of computerized prescriptions the pharmacist collects data about possible toxicities of every grade.

Results: From August-October 2002, 675 chemotherapies were administered. Seventy-two patients developed GI toxicity at various grades, nine of grade 3 and two of grade 4. Regimens with fluorouracil, carboplatin, cisplatin and oxaliplatin were highly involved in GI toxicity. Eighty-seven patients developed myelosuppression, two of grade 3 and 33 of grade 4. Regimens with epirubicin, cyclophosphamide, paclitaxel, cisplatin and carboplatin were highly involved in myelosuppression. After the first report, oncologists and pharmacists decided to stop collecting data in order to improve the reporting system and to plan regular meetings.

Conclusions: A reliable reporting system is a valuable tool for oncologists to manage toxicity and to evaluate chemotherapy regimens. Assessing chemotherapy toxicity is a good opportunity for pharmacists to take part in preventing toxicity and reducing patient's discomfort.