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Lung India. 2019 Jan-Feb;36(1):32-37. doi: 10.4103/lungindia.lungindia_321_17.

Adverse effects observed in lung cancer patients undergoing first-line chemotherapy and effectiveness of supportive care drugs in a resource-limited setting.

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Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.



Lung cancer (LC) chemotherapy results in several adverse events (AEs). Data regarding supportive care medications (SCMs) offered to prevent/treat AEs in resource-limited settings are lacking. A prospective observational study was carried out to find the effectiveness of SCMs in real-life setting.


Newly diagnosed LC patients receiving first-line chemotherapy at a tertiary referral center in North India (from July 2014 to September 2015) were enrolled. Incidence, timing of onset, duration, and grades of chemotherapy-related AEs were recorded. We assessed compliance to mandatory SCMs using a structured questionnaire. Patients also recorded various symptoms, frequency of need-based SCMs, visits to local practitioners, and hospitalization (if any) during the intercycle period.


Of the 112 patients enrolled, majority were males (83.9%, n = 94), current/ex-smokers (82.1%, n = 92), had advanced stage (Stage IIIB = 33.9% [n = 38] and Stage IV = 46.4% [n = 52]), and were non-small cell lung cancer (72.3%, n = 81). AEs were reported in 566 cycles (94%) out of a total of 602 chemotherapy cycles. Diarrhea was the most common AE (180 cycles, 29.9%) developing after a mean (standard deviation) duration of 3.6 (2.5) days and lasting for 4 (3.3) days. Vomiting (138 cycles, 22.9%) and constipation (121 cycles, 20.1%) were other common AEs. Grade 3/4 AEs occurred in 6.9% (39/566) cycles. Need-based SCMs were required in 479 of the 566 cycles (84.6%). Proportion of patients with Grade 3/4 AEs and hospitalization was highest for mucositis (16.1% Grade 3/4 and 9.7% hospitalized); followed by vomiting (10.1% Grade 3/4 and 8.7% hospitalized). Anemia was seen in 441 of 602 chemotherapy cycles (73.3%). Frequency and severity of anemia continued to increase with each chemotherapy cycle.


LC chemotherapy has a high prevalence of AEs. However, the majority are low grade recovering with need-based SCMs, without any need for hospitalization.


Adenocarcinoma; anemia; chemoradiotherapy; malignancy; toxicity

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