Naruto Taira
   Department   Kawasaki Medical School  Kawasaki Medical School, Department of Breast and Thyroid Surgery,
   Position   Professor
Article types 原著
Language English
Peer review Peer reviewed
Title Prospective cohort study of febrile neutropenia in breast cancer patients administered with neoadjuvant and adjuvant chemotherapies: CSPOR-BC FN study.
Journal Formal name:Breast (Edinburgh, Scotland)
Abbreviation:Breast
ISSN code:15323080/09609776
Domestic / ForeginForegin
Publisher ELSEVIER
Volume, Issue, Page 56,pp.70-77
Author and coauthor Ishikawa Takashi, Sakamaki Kentaro, Narui Kazutaka, Nishimura Hideki, Sangai Takafumi, Tamaki Kentaro, Hasegawa Yoshie, Watanabe Ken-Ichi, Suganuma Nobuyasu, Michishita Shintaro, Sugae Sadatoshi, Aihara Tomohiko, Tsugawa Koichiro, Kaise Hirose, Taira Naruto, Mukai Hirofumi,
Publication date 2021/04
Summary BACKGROUND:As Asians are more vulnerable to febrile neutropenia (FN) than Caucasians, evaluations of FN incidence and risk factors in Asians are important for the appropriate use of primary pegfilgrastim (PEG-G).PATIENTS AND METHODS:Japanese breast cancer patients receiving standard adjuvant chemotherapies were prospectively enrolled in multicenter institutions from August 2015 to July 2017. FN was evaluated from 2 treatment policies: true FN (T-FN): ≥37.5 °C, grade 4 neutropenia, mandatory hospital visit (visiting); surrogate FN (S-FN): ≥37.5 °C, oral antibiotic, no mandatory visit (non-visiting). PEG-G was used at the physicians' discretion. The primary endpoint was FN incidence during all cycles. Multivariate logistic regression analysis was performed to identify T-FN risk factors.RESULTS:Of 1005 enrolled patients, 980 women treated with FEC, E(A)C, and TC were analyzed. The FN incidence proportions in all patients were 22.5%, 27.5%, and 33.9% for FEC, E(A)C, and TC, respectively. Those of T-FN were 27.7%, 22.4%, and 36.6%; those of S-FN were 17.3%, 32.4%, and 31.5% with more frequent primary PEG-G usage. The relative dose intensity (RDI) of the 3 regimens was ≥0.85 in both groups. In the analysis of risk factors, TC (odds ratio = 2.67), age ≥ 65 years (2.24), and pretreatment absolute neutrophil count (ANC)/1000 μl (0.8) remained significant.CONCLUSIONS:FN incidences were above 20% in the 3 regimens, with TC showing the highest. RDI was maintained at a high level in both visiting and non-visiting groups. Patient-related risk factors were age and pretreatment ANC.
DOI 10.1016/j.breast.2021.01.005
PMID 33631458