Hospitalization during chemotherapy for small cell lung cancer

Ninety patients with small cell lung cancer, who received combination chemotherapy, were studied with regard to hospitalization during the treatment period. Chemotherapy was discontinued in case of tumour progression, or, if progression did not occur, after 18 months. The mean hospitalization time was 18 days per patient which constituted 6.7% of the total treatment time in all 90 patients. The hospitalization rate significantly decreased during the first 10 weeks of treatment, and then remained constantly low, with an average hospital time of 3.7 days per patient during maintenance chemotherapy, accounting for 2% of the total maintenance treatment time. Tumour-associated disability was a major purpose for hospital admissions, accounting for 69% of the hospital time during treatment. Except for the first treatment course, which was routinely given in hospital, chemotherapy was administered on an out-patient basis, and only four patients were admitted to hospital to receive maintenance treatment. In these patients, comorbidity and long-distance living may have contributed to the need for hospitalization. Sixteen patients were admitted to hospital at different times of treatment because of treatment complications, mainly severe infections and haemorrhages. It is concluded, that hospitalization rate is a useful and easily understood treatment outcome measure, which, in our study, implied that patients who responded to chemotherapy also gained an improved social mobility in terms of days outside the hospital, although this should not be interpreted as a comprehensive quality of life measure.