Prevalence and factors associated with chemotherapy-induced adverse events in cancer treatment centers in Amhara national regional state comprehensive referral hospitals, 2024: multicenter prospective follow up study

Chemotherapy drugs remain the gold standard treatment for cancer. However, the side effects limit chemotherapy treatment and make treatment outcome poor. This makes chemotherapy side effects a big public health problem globally. To assess prevalence and factors associated with chemotherapy-induced adverse events in cancer treatment centers in Amhara national regional state comprehensive referral hospitals, Norwest Ethiopia 2024. Multi-center prospective observational study was conducted. Data was collected using questionnaire and checklist. Adverse events were collected and graded using National Cancer Institute Common Terminology CTCAE version 4.0. Data was transformed from Epi data to SPSS and logistic regression analysis was done. Both crude and adjusted odds ratio were used to assess the strength of association. Variables with a p-value of less than 0.05 were considered as statistically significant. A total of 572 patients were included in the study with a response rate of 99.5%. The overall prevalence of chemotherapy related adverse events was 78.49% with (95%, CI = 0.7783–0.7817). Cisplatin causes adverse events in 152 (95%), oxaliplatin 59 (100%), paclitaxel 28 (100%), docetaxel 42 (76.4%), gemcitabine 68 (68%) patients, 5-Flurouracil 65 (51.2%) and cyclophosphamide 10 (29.4%) patients respectively. The commonest severe (grades 3–4) adverse events were peripheral neuropathy or pain (36.7%), nausea and vomiting (28.5%), hair loss (22.9%), fatigue (22%), itching (19.1%), cyanosis (18%), leukopenia (16.9%) and diarrhea (16.3%). Being female (AOR = 4.201, CI = 2.580–6.217), history of motion (AOR = 3.001, CI = 2.410–5.201), history of morning sickness (AOR = 1.610, CI = 101 − 3.1), second cycle chemotherapy (AOR = 2.701, CI = 201 − 8.09) and third cycle of chemotherapy (AOR = 3.201, CI = 2.91–5.302) were associated with chemotherapy related adverse events. The prevalence of chemotherapy-induced adverse events was high in the study settings. We recommend early cycle by cycle risk assessment of patients and management of adverse events. Additionally, training should be given for oncologic nurses about the risk assessment and management of adverse events. High emphasis should be given for patients who will receive oxaliplatin, cisplatin, paclitaxel, docetaxel and gemcitabine.