Chemotherapy in cancer patients undergoing haemodialysis: A nationwide study in Japan

Taro Funakoshi, Takahiro Horimatsu, Michio Nakamura, Koichi Shiroshita, Koichi Suyama, Masashi Mukoyama, Takuro Mizukami, Tsutomu Sakurada, Eishi Baba, Kazuhiko Tsuruya, Akira Nozaki, Kensei Yahata, Yukinori Ozaki, Yoshifumi Ubara, Hisateru Yasui, Akihiro Yoshimoto, Shingo Fukuma, Naoya Kondo, Takeshi Matsubara, Kazuo MatsubaraShunichi Fukuhara, Motoko Yanagita, Manabu Muto

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Abstract

Background Cancer is a major cause of death in patients undergoing haemodialysis. However, information about the actual clinical practice of chemotherapy for patients with cancer undergoing haemodialysis is lacking. We conducted a nationwide survey using questionnaires on the clinical practice of chemotherapy for such patients. Patients and methods The nationwide survey included patients undergoing haemodialysis who were subsequently diagnosed with cancer in 20 hospitals in Japan from January 2010 to December 2012. We reviewed their clinical data, including cancer at the following primary sites: kidney, colorectum, stomach, lung, liver, bladder, pancreas and breast. The questionnaires consisted of the following subjects: (1) patient characteristics; (2) regimen, dosage and timing of chemotherapy; and (3) clinical outcome. Results Overall, 675 patients were registered and assessed for main primary cancer site involvement. Of 507 patients with primary site involvement, 74 patients (15%) received chemotherapy (44 as palliative chemotherapy and 30 as perioperative chemotherapy). The most commonly used cytotoxic drugs were fluoropyrimidine (15 patients), platinum (8 patients) and taxane (8 patients), and the dosage and timing of these drugs differed between institutions; however, the dosage of molecular targeted drugs (24 patients) and hormone therapy drugs (15 patients) was consistent. The median survival time of patients receiving palliative chemotherapy was 13.0 months (0.1-60.3 months). Three patients (6.8%) died from treatment-related causes and nine patients (20%) died of causes other than cancer. Of the 30 patients who received perioperative chemotherapy, 6 (20%) died of causes other than cancer within 3 years after the initiation of chemotherapy. Conclusion Among the haemodialysis patients with cancer who received chemotherapy, the rates of mortality from causes other than cancer might be high for both palliative and perioperative chemotherapy. Indications for the use of chemotherapy in patients undergoing haemodialysis should be considered carefully.

Original languageEnglish
Article numbere000301
JournalESMO Open
Volume3
Issue number2
DOIs
Publication statusPublished - Feb 1 2018

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Funakoshi, T., Horimatsu, T., Nakamura, M., Shiroshita, K., Suyama, K., Mukoyama, M., Mizukami, T., Sakurada, T., Baba, E., Tsuruya, K., Nozaki, A., Yahata, K., Ozaki, Y., Ubara, Y., Yasui, H., Yoshimoto, A., Fukuma, S., Kondo, N., Matsubara, T., ... Muto, M. (2018). Chemotherapy in cancer patients undergoing haemodialysis: A nationwide study in Japan. ESMO Open, 3(2), [e000301]. https://doi.org/10.1136/esmoopen-2017-000301