Cousin Sophie, Le Rhun Emilie, Mailliez Audrey, Fournier Charles, Bonneterre Jacques
Centre Oscar-Lambret, département sénologie, Lille, France.
Bull Cancer. 2012 Jul-Aug;99(7-8):75-80. doi: 10.1684/bdc.2012.1607.
Chemotherapy for the treatment of early-stage breast cancer (ESBC) patients improves survival outcomes. However, its most common acute toxicity is myelosuppression, which can reduce the delivered dose and compromise the survival benefit. Because FEC100-docetaxel (FEC100-D) is a common protocol for ESBC, we evaluated its febrile neutropenia (FN) incidence and the role of its hematological toxicity on the individual relative dose-intensity (RDI).
It is a French single-center, observational, retrospective study. Patients received adjuvant/neoadjuvant FEC100-D treatment, without primary prophylaxis by granulocyte colony-stimulating factors (G-CSF). The neutrophil count the day before the planned chemotherapy cycle had to be over 1,500.mm(-3) for the treatment to be administered. Data collected included: date and dose of chemotherapy cycles, FN and high grade of hematological toxicity occurrence for each course, G-CSF prescription.
One thousand, seven hundred and fifty-seven cycles in 284 patients were delivered. FN was observed in 4.9% (n = 14) of the patients, without hospitalizations or deaths after. Grade 3-4 neutropenia occurred in 5.8% of the cycles, during the first cycle in 40% of cases. Seventeen percent of our patients received less than 85% of RDI.
The hematotoxicity of this treatment is acceptable. The risk of FN is low. No G-CSF primary prophylaxis is needed without additional risk factor.
化疗用于治疗早期乳腺癌（ESBC）患者可改善生存结局。然而，其最常见的急性毒性是骨髓抑制，这可能会降低给药剂量并损害生存获益。由于FEC100-多西他赛（FEC100-D）是ESBC的常用方案，我们评估了其发热性中性粒细胞减少症（FN）的发生率及其血液学毒性对个体相对剂量强度（RDI）的作用。
这是一项法国单中心、观察性、回顾性研究。患者接受辅助/新辅助FEC100-D治疗，未使用粒细胞集落刺激因子（G-CSF）进行一级预防。计划化疗周期前一天的中性粒细胞计数必须超过1500/mm³才能进行治疗。收集的数据包括：化疗周期的日期和剂量、每个疗程的FN和血液学毒性的高级别发生情况、G-CSF处方。
284例患者共进行了1757个周期的治疗。4.9%（n = 14）的患者出现FN，之后无住院或死亡情况。5.8%的周期出现3-4级中性粒细胞减少，其中40%的病例发生在第一个周期。17%的患者接受的RDI低于85%。
该治疗的血液毒性是可接受的。FN风险较低。在没有其他风险因素的情况下，无需进行G-CSF一级预防。
