Patients with advanced lung cancer receiving chemotherapy in real-world settings were almost eight times more likely to be hospitalized during treatment than those participating in clinical trials.
What's more, very few clinical trials even report how often participants are hospitalized during the research, the study authors found.
"Clinical trials should be routinely reporting their hospitalization rates so we know what to expect," said senior author Dr. Monika Krzyzanowska of the Princess Margaret Cancer Center in Toronto, Canada. "I think that (hospitalization is) actually much more common than we ever anticipated," Krzyzanowska said.
For the new meta-analysis, released online September 17 in JAMA Oncology, the researchers looked at data on patients receiving chemotherapy for metastatic non-small-cell lung cancer, from five reports of clinical trials with a total of 3962 people that specified how many hospitalizations occurred, and five studies involving 8624 people receiving chemotherapy in real-world settings.
Overall, 51% of the real-world patients were hospitalized during their treatments, compared to 16% of those in clinical trials.
Some of the research looked at factors related to the risk of hospitalization like the type of chemotherapy used and hospital performance measures, but results varied from study to study and Krzyzanowska said that she can't say with confidence which factors may be tied to an increased risk of being hospitalized.
But, she said, similar patterns of high hospitalizations are likely to be found among people with other cancers and on other types of treatments.
"I think this is unfortunately a common phenomenon across disease site and treatment regimen," Krzyzanowska said.
Knowing how much time patients may spend in hospitals during chemotherapy might help them and their doctors in deciding which treatment is right, Krzyzanowska said.
"I think the low-hanging fruit is that clinical trials should start reporting hospitalizations," she said of the findings.
With that kind of data, the researchers suggest, scientists can calculate the risk of hospitalization per month of chemotherapy and ultimately provide that to patients.
Krzyzanowska also said she'd like to look at what factors drive hospitalizations among cancer patients receiving chemotherapy.
"I definitely think there is a substantial portion of people whose symptoms can be managed earlier so they don't end up in the hospital," she said.