BMC Cancer. 2026 Jul 20. doi: 10.1186/s12885-026-16554-6. Online ahead of print.
ABSTRACT
BACKGROUND: Gastrointestinal tract (GIT) cancers are a leading cause of cancer-related death worldwide. Chemotherapy, a cornerstone of treatment, often causes toxicities that can compromise clinical outcomes. However, evidence on the prevalence and risk factors of chemotherapy-induced toxicity among GIT cancer patients in Ethiopia remains limited. Therefore, this study aimed to assess the prevalence and associated factors of chemotherapy-induced toxicity among GIT cancer patients at two Tertiary Care Hospitals in Addis Ababa, Ethiopia.
METHODS: A hospital-based prospective observational study was conducted among patients enrolled prior to chemotherapy initiation and followed biweekly until treatment completion. Adverse drug reactions (ADRs) were collected from patient interviews and medical records, and assessed using the Naranjo algorithm, Hartwig-Siegel scale, and National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5. Data were analyzed using descriptive statistics and logistic regression in SPSS version 26, with P < 0.05 considered statistically significant.
RESULTS: The mean (± SD) age of patients was 51.59 (± 11.18) years. A total of 1499 ADRs were reported, of which 47.4% (n = 710) were hematological toxicities. Based on the Naranjo scale, 54.8% of the ADRs were classified as probable, while the Hartwig-Siegel scale severity score classified 53.7% as mild ADRs. According to NCI-CTCAE v5.0 grading score, 37.1% of the ADRs were graded ≥ 3. Poor pathological grade (AOR: 4.410, 95% CI: 1.823-10.666, p = 0.001), low baseline hemoglobin (AOR: 4.456, 95% CI: 2.021-9.824, p = 0.001) and low absolute neutrophil counts (AOR: 2.237, 95% CI: 1.061-4.717, p = 0.034) were significantly associated with severe ADRs. Granulocyte colony-stimulating factor (G-CSF) use was independently associated with lower odds of high-grade ADRs (AOR = 0.508, 95% CI: 0.260-0.995, p = 0.048).
CONCLUSION: Chemotherapy-induced toxicities were highly prevalent among GIT cancer patients, with a substantial proportion experiencing severe toxicities. Poor pathological grade, low baseline hemoglobin, and low absolute neutrophil count were significantly associated with high-grade toxicities, while G-CSF use was protective. These findings highlight the need for improved toxicity management and personalized treatment strategies in Ethiopian oncology practice.
PMID:42477648 | DOI:10.1186/s12885-026-16554-6
