e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

An analysis of same-day cancellations of systemic anti-cancer therapy in a day therapy unit (#354)

Whiter Tang 1 , Reizel Parij 2 , Alice Nguyen 2 , Michael Soriano 1
  1. Pharmacy, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
  2. CareFully Solutions, Sydney, New South Wales, Australia

Aim: The aim of this study was to identify potential factors or trends associated with same-day cancellations of systemic anti-cancer therapy in a day therapy unit.

Method: This study was conducted in a 44-chair day therapy unit in a metropolitan cancer specialty hospital. Patients cancelled on the same day of treatment were identified over a 28 day period and these patients were analysed by patient demographics, disease type, prescribed regimen, cycle number and reason for cancellation.

Results: Over the 28 days, 91 treatment sessions out of 1667 booked appointments (5%) were cancelled on the same day. This involved 138 cancelled doses where 59 (43%) of these doses were prepared in advance, either compounded in-house (93%) or sourced externally (7%). Bone marrow toxicity was the top reason for cancellation (39%) but non-haematological reasons accounted for the majority of cancellations such as disease progression (31%), adverse effects (22%) and patient preference (6%). The most common treatments cancelled were carboplatin (11%) and paclitaxel (10%) with bone marrow toxicity being a major reason for delay. The average age of cancelled patients was 62 and there were 55% female compared to 44% male. Cycle two was the most common cycle number to be cancelled (24%) where 50% of these were due to bone marrow toxicity. There was no significant pattern to the type of cancer nor whether the patient had previous cancellations.

Conclusion: There are various reasons for same-day cancellations with bone marrow toxicity and disease progression accounting for more than half of all cancellations. These reasons demonstrate that same-day cancellations are mostly unpredictable in nature, but this study forms a good baseline for future evaluations on ways to reduce the impact of same-day cancellations.