BACKGROUND: Many oncologists reduce chemotherapy doses in obese patients due to fear of excess toxic effect from very large weight-based calculations. While recent guidelines advise against this practice, quantitative summarization of the supporting evidence is not available. MATERIALS AND METHODS: We systematically identified studies that compared toxic effect or survival outcomes between obese and normal-weight adults receiving chemotherapy dosed by actual body weight (ABW). We pooled odds ratios (OR) and 95% confidence intervals (CI) using random-effects models. RESULTS: Of 5490 records screened, 12 studies representing 9314 relevant patients met inclusion criteria. The large majority of reported toxic effect and survival outcomes did not statistically differ between obese and normal-weight subjects. Exceptions included five studies in which one or more toxic effect or survival outcomes statistically favored obese patients, and one study that statistically favored normal-weight patients. Pooling usable data, rates of toxic effects were similar or lower in obese patients (grade 3/4 hematologic toxic effect: OR 0.73, CI 0.55-0.98, 4 studies; grade 3/4 nonhematologic toxic effect: OR 0.98, CI 0.76-1.26, 3 subgroups; any grade 3/4 toxic effect: OR 0.75, CI 0.65-0.87, three studies). CONCLUSIONS: Obese patients receiving chemotherapy based on ABW experience similar or lower rates of toxic effects compared with normal-weight patients, and survival outcomes do not differ.
BACKGROUND: Many oncologists reduce chemotherapy doses in obesepatients due to fear of excess toxic effect from very large weight-based calculations. While recent guidelines advise against this practice, quantitative summarization of the supporting evidence is not available. MATERIALS AND METHODS: We systematically identified studies that compared toxic effect or survival outcomes between obese and normal-weight adults receiving chemotherapy dosed by actual body weight (ABW). We pooled odds ratios (OR) and 95% confidence intervals (CI) using random-effects models. RESULTS: Of 5490 records screened, 12 studies representing 9314 relevant patients met inclusion criteria. The large majority of reported toxic effect and survival outcomes did not statistically differ between obese and normal-weight subjects. Exceptions included five studies in which one or more toxic effect or survival outcomes statistically favored obesepatients, and one study that statistically favored normal-weight patients. Pooling usable data, rates of toxic effects were similar or lower in obesepatients (grade 3/4 hematologic toxic effect: OR 0.73, CI 0.55-0.98, 4 studies; grade 3/4 nonhematologic toxic effect: OR 0.98, CI 0.76-1.26, 3 subgroups; any grade 3/4 toxic effect: OR 0.75, CI 0.65-0.87, three studies). CONCLUSIONS:Obesepatients receiving chemotherapy based on ABW experience similar or lower rates of toxic effects compared with normal-weight patients, and survival outcomes do not differ.
Authors: Vicki A Morrison; Linda McCall; Hyman B Muss; Aminah Jatoi; Harvey J Cohen; Constance T Cirrincione; Jennifer A Ligibel; Jacqueline M Lafky; Arti Hurria Journal: J Geriatr Oncol Date: 2017-12-08 Impact factor: 3.599
Authors: Marco Gallo; Valerio Adinolfi; Viola Barucca; Natalie Prinzi; Valerio Renzelli; Luigi Barrea; Paola Di Giacinto; Rosaria Maddalena Ruggeri; Franz Sesti; Emanuela Arvat; Roberto Baldelli; Emanuela Arvat; Annamaria Colao; Andrea Isidori; Andrea Lenzi; Roberto Baldell; M Albertelli; D Attala; A Bianchi; A Di Sarno; T Feola; G Mazziotti; A Nervo; C Pozza; G Puliani; P Razzore; S Ramponi; S Ricciardi; L Rizza; F Rota; E Sbardella; M C Zatelli Journal: Rev Endocr Metab Disord Date: 2020-10-06 Impact factor: 6.514