Abstract

BackgroundCancer patients undergo routine computed-tomography (CT) scans and, therefore, iodinated contrast media (ICM) administration. It is not known whether a time-dependent correlation exists between chemotherapy administration, contrast enhanced CT and onset of acute ICM-related adverse reactions (ARs).MethodsAll consecutive contrast-enhanced CTs performed from 1 January 2010 to 31 December 2012 within 30 days of the last chemotherapy administration were retrospectively reviewed. Episodes of acute ICM-related ARs were reported to the pharmacovigilance officer. We analyzed time to CT evaluation calculated as the time elapsed from the date of the CT performed to the date of the last chemotherapy administration. Patients were classified into 4 groups based on the antineoplastic treatment: platinum-based, taxane-based, platinum plus taxane and other group.ResultsOut of 10,472 contrast-enhanced CTs performed, 3,945 carried out on 1,878 patients were considered for the study. Forty acute ICM-related ARs (1.01%; 95% CI, 0.70-1.33) were reported. No differences were seen among immediate (within 10 days of the last chemotherapy administration), early (11–20 days) and delayed (21–30 days) CTs. Median time to CT in patients who experienced an acute ICM-related AR by treatment group was not statistically different: 20 days (range 6–30), 17 days (range 5–22), 13 days (range 8–17), 13 days (range (2–29) for the platinum, taxane, platinum plus taxane and other group, respectively (P =0.251).ConclusionsOur results did not reveal any correlation between time to CT and risk of acute ICM-related ARs in cancer patients.

Highlights

  • Cancer patients undergo routine computed-tomography (CT) scans and, iodinated contrast media (ICM) administration

  • Out of 3,945 contrast-enhanced CT scans, 40 acute ICM-related adverse reactions (ARs) (1.01%; 95% CI, 0.70-1.33) were reported during the study time period

  • We compared the risk of ICM-related ARs between immediate, early and delayed contrast-enhanced CT

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Summary

Introduction

Cancer patients undergo routine computed-tomography (CT) scans and, iodinated contrast media (ICM) administration It is not known whether a time-dependent correlation exists between chemotherapy administration, contrast enhanced CT and onset of acute ICM-related adverse reactions (ARs). It should be considered that all main systemic agents used in cancer treatment today are associated with possible hypersensitivity reactions, there are differences among agents in terms of the onset time of the symptoms [7,8]. Since both ICM and taxanes may induce reactions at first administration [9], it may be assumed that both drugs act via similar immune-mediated mechanisms. In order to determine the risk/benefit ratio on the time of evaluation of the disease and to evaluate if the risk may be time-dependent, we analysed the time elapsing between the contrast-enhanced CT scan, the most recent chemotherapy administration and the onset time of the ICM-related ARs in a consecutive cohort of cancer patients

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