title: Metabolic toxicities in patients undergoing treatment for nonhematological malignancy: A cross-sectional study.
abstract: OBJECTIVE
  The objective of this study was to evaluate the prevalence of metabolic toxicities in patients with different nonhematological malignancies admitted in oncology ward of a tertiary cancer care center while on treatment.
  
  
  METHODS
  We did this cross-sectional study over a period of 7 months (January-July 2013) for all adult patients (n= 280) who, while undergoing anti-cancer therapy at our center, got admitted to our oncology inpatient ward with metabolic toxicity. Grading of toxicity was done using National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0.
  
  
  RESULTS
  A total of 46 events of metabolic toxicities were noted in 31 patients over this period. The most common of them was hyperglycemia (n= 10). The others were hypokalemia (n= 9), hyponatremia (n= 9), hypernatremia (n= 5), hyperkalemia (n= 5), tumor lysis syndrome (n= 4), hypercalcemia (n= 2), and grade ≤2 hypomagnesemia (n= 2). Majority of the patients were asymptomatic (n= 26). However, death occurred in five patients. Treatment interruptions took place in 19 patients. Age ≤40 years (P= 0.03), Eastern Cooperative Oncology Group performance status ≥2 (P= 0.023), history of addiction (P= 0.02), comorbidities (P= 0.037) were associated with increased risk of having metabolic toxicities on univariate analysis. While on multivariate analysis, only age, performance status, and history of addiction retained their statistical significance. Age ≤40 years (P= 0.02), use of more than one modality of treatment (P= 0.013), and hyperglycemia (P= 0.037) were associated with higher risk of death.
  
  
  CONCLUSIONS
  Metabolic toxicities are common phenomena among cancer patients, especially those with young age, comorbidities, and having history of addictions. In young age, they might even be fatal, especially when they are treated with combined modality of treatment.
authors.affiliation: Department of Radiation Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Subhash
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Radiation Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Kunhi Parambath
authors.initials: KP
authors.lastname: Haresh
authors.affiliation: Department of Radiation Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Soumyajit
authors.initials: S
authors.lastname: Roy
authors.affiliation: Department of Radiation Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Lakhan
authors.initials: L
authors.lastname: Kashyap
authors.affiliation: Department of Radiation Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Narayan
authors.initials: N
authors.lastname: Adhikari
authors.affiliation: Department of Radiation Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rambha
authors.initials: R
authors.lastname: Pandey
authors.affiliation: Department of Radiation Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Dayanand
authors.initials: D
authors.lastname: Sharma
authors.affiliation: Department of Radiation Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Pramod Kumar
authors.initials: PK
authors.lastname: Julka
authors.affiliation: Department of Radiation Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Goura Kishor
authors.initials: GK
authors.lastname: Rath
keywords: Malignancies; metabolic toxicities; nonhematological