The first major report using world-first systemic anticancer treatment (SACT) data has been published by Lancet Oncology shows that age, general wellbeing and other factors can affect 30-day mortality following chemotherapy for breast and lung cancer.
- Most of the people who died within 30 days were receiving palliative treatment (where the cancer cannot be cured and chemotherapy is given to relieve symptoms and improve quality of life): 569 breast cancer patients and 720 lung cancer patients.
- There were also a small number of deaths in those patients given treatment with the intention to cure: 41 breast cancer patients and 53 lung cancer patients.
- There were no clusters of these deaths. The majority of hospitals had no curative intent deaths at all; those deaths were scattered across 53 different Trusts (just under half of the total).
- Older patients with more advanced disease, who also had other illnesses and a worse performance status, were more likely to die.
- Patients with a high body mass index (BMI) were less likely to die than those with a low BMI.
- Patients were most likely to die when being given their first round of chemotherapy.
Dr Jem Rashbass, Cancer Lead for PHE, said: We are privileged in England to have access to such high quality cancer data. This world-leading database will allow us to monitor the quality of chemotherapy treatment given to all patients across the NHS in near real-time.
Chemotherapy is a vital part of cancer treatment and is a large reason behind the improved survival rates over last 4 decades. However, it is powerful medication with significant side effects and often getting the balance right on which patients to treat aggressively can be hard. Studies like this help improve our understanding of how people are affected by chemotherapy in the real world and most importantly help us to treat patients better.
Those hospitals whose death rates are outside the expected range have had the findings shared with them and we have asked them to review their practice and data.
Lead clinical author Professor David Dodwell, Institute of Oncology, St James Hospital, Leeds said: This is the first time that 30-day mortality following chemotherapy has been investigated on a national level. Age, general wellbeing, and whether patients are treated with palliative or curative intent are all factors that affect the risk of early mortality of breast and lung cancer patients. The factors we have identified should be a focus of discussions about treatment between patients and their clinicians to allow better informed decisions. The SACT data and other data sources in NCRAS are a critically important resource for future research.
Professor Peter Johnson, Cancer Research UK’s Chief Clinician, said: This is the first time this type of data has been collected and analysed so extensively. This was a huge undertaking but it now means we have a way to measure if the health service is getting better at delivering the right drugs to the right patients. It’s vital that this data continues to be collected and analysed routinely so that we can make sure it is continually improving.