Relative dose intensity of systemic chemotherapy in an outpatient cancer center

Abstract

Objective. This study was undertaken to determine the averagerelative dose intensity (RDI) of chemotherapy administeredto patients in a community-based outpatient cancercenter. Methods. A retrospective review of medical recordsin an outpatient cancer center was conducted for patientsinitiating systemic chemotherapy in 2007 for a diagnosis oflymphoma, breast, lung, ovary, or colon cancer. Eighty-fourrecords meeting the inclusion criteria were reviewed for demographicinformation, primary tumor type, chemotherapyregimen, staging at diagnosis, presence of disease progression,and mortality status. Regimen data included: chemotherapeuticagents used, dosages administered, dates of administration,treatment intent (adjuvant vs. metastatic), andgranulocyte colony-stimulating factor (G-CSF) usage percycle. Mean summary statistics were calculated and averageRDI was analyzed. Results. The overall RDI at our institutionwas 83% (n=65). The RDI for those receiving adjuvant chemotherapywas 85% (n=51), whereas for those receiving chemotherapyfor metastatic disease the RDI was 76% (n=14).Fifty-four percent (n=35) of the regimens met or exceededthe recommended minimum goal RDI of > 85%. Conclusions.Overall the average RDI at our institution was 83%,slightly below the goal of ≥ 85%. Patients with potentially curablemalignancies receiving adjuvant chemotherapy reachedthe threshold RDI; however, areas for quality improvementexist at our institution.