ArticleCancer chemotherapy and pharmacology2026
Association between modifications in intravenous chemotherapy dose and disease-free survival and related influencing factors in lung cancer patients: a retrospective study based on inverse probability weighting.
Article in Cancer chemotherapy and pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeLung cancer treatment options have advanced, chemotherapy continues to play a central role in its management. However, the prognostic impact of individualized chemotherapy dose modifications remains uncertain. To examine the association between intravenous chemotherapy dose variations and disease-free survival (DFS) in lung cancer patients, and to identify factors influencing dose adjustment.
methodsLung cancer patients who received chemotherapy at Xiangya Hospital, Central South University from 2016 to 2021. Patients were classified into three groups based on deviation from the standard dose: dose reduction group, standard dose group, and dose increase group. Multivariable Cox proportional hazards models and inverse probability weighting (IPW) were used to evaluate the relationship between dose changes and DFS. Multivariate logistic regression was performed to identify factors associated with dose modification.
resultsAmong 23,231 patients, 7673 received standard doses, 13,655 reduced doses and 1903 increased doses. After adjustment by multivariable Cox regression and IPW, dose reduction (HR 1.06, 95% CI 1.01-1.11; P = 0.015) and dose increase (HR 1.11, 95% CI 1.02-1.22; P = 0.022) were associated with shorter DFS; in the platinum-doublet subgroup, only dose reduction remained significant (HR 1.08, 95% CI 1.02-1.15; P = 0.007). Logistic regression identified age, sex, height, weight, pathology, TNM stage and use of targeted/immunotherapy as associated factors.
conclusionDose reduction was associated with significantly shorter DFS. Individualized dosing strategies should be based on comprehensive clinical evaluation to improve outcomes. These findings provide evidence to support rational chemotherapy planning in lung cancer care.
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