A population-based study of pulmonary monitoring and toxicity for patients with testicular cancer treated with bleomycin

Current Oncology

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Title A population-based study of pulmonary monitoring and toxicity for patients with testicular cancer treated with bleomycin
Creator Raphael, M.J.
Lougheed, M.D.
Wei, X.
Karim, S.
Robinson, A.G.
Bedard, P.L.
Booth, C.M.
Subject Testicular cancer
Treatment adverse events
Population-based outcome studies
Description Background Bleomycin is commonly used to treat advanced testicular cancer and can be associated with severe pulmonary toxicity. The primary objective of the present study was to describe the use of pulmonary function tests (pfts) and chest imaging before, during, and after treatment with bleomycin.
Methods To identify all incident cases of testicular cancer treated with bleomycin-based chemotherapy in the Canadian province of Ontario during 2005–2010, the Ontario Cancer Registry was linked with chemotherapy treat­ment records. Health administrative databases were used to describe use of pfts, chest imaging, and physician visits for respiratory complaints.
Results Of 394 patients treated with orchiectomy and chemotherapy who received at least 1 dose of bleomycin, 93% had complete chemotherapy records available. In the 4 weeks before, during, and within 2 years after finishing bleomycin-based chemotherapy, pfts were performed in 17%, 17%, and 29% of patients respectively. Chest imaging was performed in 68%, 62%, and 98% of patients in the same time periods. In the 2 years after bleomycin-based chemotherapy, 23% of treated patients had a physician visit for respiratory symptoms. That rate was substantially higher for men with greater exposure to bleomycin: 40% (24 of 60) for 10–12 doses bleomycin compared with 21% (53 of 250) for 7–9 doses and with 14% (8 of 58) for 1–6 doses (p = 0.002).
Conclusions Quality improvement initiatives are needed to increase baseline rates of chest imaging within 4 weeks of starting chemotherapy for testicular cancer; to understand why such a high proportion of men have chest imaging during bleomycin-based chemotherapy; and to mitigate the excess pulmonary toxicity seen with increasing expos­ure to bleomycin.
Publisher Multimed Inc.
Date 2020-07-31
Type info:eu-repo/semantics/article
Format application/pdf
Identifier http://www.current-oncology.com/index.php/oncology/article/view/6389
Source Current Oncology; Vol. 27 No. 6 (2020)
Language eng
Relation http://www.current-oncology.com/index.php/oncology/article/view/6389/9667
Rights Copyright (c) 2020 Current Oncology

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