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Purpose <p>Patients with metastatic or unresectable gastro-oesophageal cancers (mGECs) have poor prognoses and often face high symptom burdens and rates of disease-related complications. Second-line treatments offer modest survival gains, which need to be balanced with treatment toxicities. Time toxicity (TT) is increasingly recognised as a hidden toxicity of cancer therapy, and thus, this study aimed to quantify TT to patients undergoing second-line treatment for mGECs.</p> Methods <p>This was a retrospective cohort study across three major hospitals in Sydney, Australia. Records were reviewed for all patients who received second-line systemic therapy for mGECs over 10 years. TT was defined as the number of days patients spent physically interacting with the healthcare system.</p> Results <p>Eighty patients were identified, with the majority male (83%) and a median age of 64&#xa0;years. The median time on second-line treatment was 2.4&#xa0;months, and the median overall survival from the commencement of second-line treatment was 5.8&#xa0;months. Patients spent a median 25% of days in physical contact with healthcare, of which 20% were planned encounters (e.g. clinic appointments, scheduled investigations, and treatment days). TT was lower in patients who remained on second-line treatment for more than 2 months versus those on treatment less than 2 months (29% vs. 23%, <i>p</i> &lt; 0.001). One in eight patients died within 30 days of receiving second-line treatment.</p> Conclusion <p>Patients on second-line treatment for mGEC spent 1 in 4&#xa0;days in contact with healthcare, and 30-day mortality following systemic treatment was high. These findings may guide decisions and informed consent surrounding second-line treatment in mGECs.</p>

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Time toxicity associated with treatment of metastatic or unresectable gastro-oesophageal cancers in the second-line setting

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月29日

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  • Rebecca Han Nguyen,
  • Joanne Tang,
  • Udit Nindra,
  • Aflah Roohullah,
  • Robert Yoon,
  • Annette Tognela,
  • Stephanie Hui-Su Lim,
  • Ray Asghari,
  • Wei Chua,
  • Weng Ng

摘要

Purpose

Patients with metastatic or unresectable gastro-oesophageal cancers (mGECs) have poor prognoses and often face high symptom burdens and rates of disease-related complications. Second-line treatments offer modest survival gains, which need to be balanced with treatment toxicities. Time toxicity (TT) is increasingly recognised as a hidden toxicity of cancer therapy, and thus, this study aimed to quantify TT to patients undergoing second-line treatment for mGECs.

Methods

This was a retrospective cohort study across three major hospitals in Sydney, Australia. Records were reviewed for all patients who received second-line systemic therapy for mGECs over 10 years. TT was defined as the number of days patients spent physically interacting with the healthcare system.

Results

Eighty patients were identified, with the majority male (83%) and a median age of 64 years. The median time on second-line treatment was 2.4 months, and the median overall survival from the commencement of second-line treatment was 5.8 months. Patients spent a median 25% of days in physical contact with healthcare, of which 20% were planned encounters (e.g. clinic appointments, scheduled investigations, and treatment days). TT was lower in patients who remained on second-line treatment for more than 2 months versus those on treatment less than 2 months (29% vs. 23%, p < 0.001). One in eight patients died within 30 days of receiving second-line treatment.

Conclusion

Patients on second-line treatment for mGEC spent 1 in 4 days in contact with healthcare, and 30-day mortality following systemic treatment was high. These findings may guide decisions and informed consent surrounding second-line treatment in mGECs.