Systemic therapy and radiotherapy related complications and subsequent hospitalisation rates: a systematic review

Article

Mahumud, Rashidul Alam, Shahjalal, Md., Daha, Padam Kanta, Mosharaf, Md. Parvez, Hoque, Mohammad Enamul and Wawryk, Olivia. 2024. "Systemic therapy and radiotherapy related complications and subsequent hospitalisation rates: a systematic review." BMC Cancer. 24 (1). https://doi.org/10.1186/s12885-024-12560-8

Article Title	Systemic therapy and radiotherapy related complications and subsequent hospitalisation rates: a systematic review
ERA Journal ID	15804
Article Category	Article
Authors	Mahumud, Rashidul Alam, Shahjalal, Md., Daha, Padam Kanta, Mosharaf, Md. Parvez, Hoque, Mohammad Enamul and Wawryk, Olivia
Journal Title	BMC Cancer
Journal Citation	24 (1)
Article Number	826
Number of Pages	15
Year	2024
Publisher	BioMed Central Ltd.
Place of Publication	United Kingdom
ISSN	1471-2407
Digital Object Identifier (DOI)	https://doi.org/10.1186/s12885-024-12560-8
Web Address (URL)	https://bmccancer.biomedcentral.com/articles/10.1186/s12885-024-12560-8
Abstract	Background Hospitalisation resulting from complications of systemic therapy and radiotherapy places a substantial burden on the patient, society, and healthcare system. To formulate preventive strategies and enhance patient care, it is crucial to understand the connection between complications and the need for subsequent hospitalisation. This review aimed to assess the existing literature on complications related to systemic and radiotherapy treatments for cancer, and their impact on hospitalisation rates. Methods Data was obtained via electronic searches of the PubMed, Scopus, Embase and Google Scholar online databases to select relevant peer-reviewed papers for studies published between January 1, 2000, and August 30, 2023. We searched for a combination of keywords in electronic databases and used a standard form to extract data from each article. The initial specific interest was to categorise the articles based on the aspects explored, especially complications due to systemic and radiotherapy and their impact on hospitalisation. The second interest was to examine the methodological quality of studies to accommodate the inherent heterogeneity. The study protocol was registered with PROSPERO (CRD42023462532). Findings Of 3289 potential articles 25 were selected for inclusion with ~ 34 million patients. Among the selected articles 21 were cohort studies, three were randomised control trials (RCTs) and one study was cross-sectional design. Out of the 25 studies, 6 studies reported ≥ 10 complications, while 7 studies reported complications ranging from 6 to 10. Three studies reported on a single complication, 5 studies reported at least two complications but fewer than six, and 3 studies reported higher numbers of complications (≥ 15) compared with other selected studies. Among the reported complications, neutropenia, cardiac complications, vomiting, fever, and kidney/renal injury were the top-most. The severity of post-therapy complications varied depending on the type of therapy. Studies indicated that patients treated with combination therapy had a higher number of post-therapy complications across the selected studies. Twenty studies (80%) reported the overall rate of hospitalisation among patients. Seven studies revealed a hospitalisation rate of over 50% among cancer patients who had at least one complication. Furthermore, two studies reported a high hospitalisation rate (> 90%) attributed to therapy-repeated complications. Conclusion The burden of post-therapy complications is emerging across treatment modalities. Combination therapy is particularly associated with a higher number of post-therapy complications. Ongoing research and treatment strategies are imperative for mitigating the complications of cancer therapies and treatment procedures. Concurrently, healthcare reforms and enhancement are essential to address the elevated hospitalisation rates resulting from treatment-related complications in cancer patients.
Keywords	Cancer patients; Systemic therapy; Radiotherapy; Hospitalisation; Length of stay; Complications
Contains Sensitive Content	Does not contain sensitive content
ANZSRC Field of Research 2020	321104. Cancer therapy (excl. chemotherapy and radiation therapy)
Byline Affiliations	University of Sydney
	North South University, Bangladesh
	Central Queensland University
	School of Business
	University of Western Australia
	University of Melbourne

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