Difference in toxicity reporting between patients and clinicians during systemic chemotherapy for urothelial carcinoma.

Abstract

347 Background: Symptomatic toxicities associated with anticancer treatments are at high risk of under-reporting by clinicians. However, insufficient evidence is available for urothelial carcinoma. To compare toxicity reporting by patients and clinicians in urothelial carcinoma patients who received systemic chemotherapy. Methods: Between June 2013 and March 2016, 100 urothelial carcinoma patients who received two courses of chemotherapy of gemcitabine plus cisplatin (GCis) or gemcitabine plus carboplatin (GCb) were included in this study. Outcome Measurements and Statistical Analysis: During chemotherapy, patients answered QLQ-C30 quality of life (QOL) questionnaires, which included questions on four toxicity-related symptoms (appetite loss, nausea, constipation, and diarrhea). Clinicians evaluated adverse events using CTCAE v4.0. Differences in toxicity reporting were retrospectively compared between patients and clinicians. Logistic regression analyses were performed to investigate potential factors for under-reporting by clinicians. Results: Toxicity under-reporting was most frequent in diarrhea (44%), followed by appetite loss (39%), constipation (33%), and nausea (22%). In total, toxicity under-reporting was observed in 72% patients. Background-adjusted logistic regression analyses showed that pretreatment QOL items, such as global and symptomatic scores, were selected as potential predictors for toxicity under-reporting by clinicians. Limitations of our study included its retrospective nature and small sample size. Conclusions: Toxicity under-reporting by clinicians is frequent in urothelial carcinoma patients who received systemic chemotherapy. Pretreatment QOL evaluation is essential to identify potential individuals at risk for toxicity under-reporting. Clinical trial information: UMIN000020784.