Department of Otolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan,
Support Care Cancer. 2013 Oct;21(10):2861-8. doi: 10.1007/s00520-013-1873-9. Epub 2013 Jun 8.
Febrile neutropenia (FN) is an oncologic emergency, and its management is critical during chemotherapy. However, little is known about FN in patients with head and neck cancer. The purpose of this study was to investigate the incidence and predictors of FN in patients with head and neck cancer.
We performed a retrospective study in a university hospital in Japan between January 2008 and December 2012. Head and neck cancer patients treated with a platinum-based regimen were included in the analysis.
FN occurred in 47 out of 138 cycles, and the incidence of FN was highest during the first cycle. Severe sepsis or more serious events were observed in 46 % of FN episodes. Patients treated with TPF (docetaxel, cisplatin, and fluorouracil) were more susceptible to FN than those treated with DC (docetaxel, cisplatin). The patient-specific risk factors revealed using univariate analysis were tube feeding, the presence of diabetes mellitus, and gastrointestinal adverse effects. Of these, logistic regression analysis demonstrated tube feeding and diabetes mellitus as independent predictors of FN.
The incidence of FN in head and neck cancer patients in the community setting is higher than previously reported. Patients receiving enteral nutrition and those with diabetes are at high risk for FN.
发热性中性粒细胞减少症（FN）是一种肿瘤急症，在化疗期间对其进行管理至关重要。然而，关于头颈部癌症患者的 FN 知之甚少。本研究的目的是调查头颈部癌症患者 FN 的发生率和预测因素。
我们在日本的一所大学医院进行了一项回顾性研究，时间为 2008 年 1 月至 2012 年 12 月。分析中包括接受铂类方案治疗的头颈部癌症患者。
138 个周期中发生了 47 次 FN，FN 的发生率在第一个周期最高。46%的 FN 发作中观察到严重脓毒症或更严重的事件。接受 TPF（多西他赛、顺铂和氟尿嘧啶）治疗的患者比接受 DC（多西他赛、顺铂）治疗的患者更容易发生 FN。单因素分析显示，患者特有的危险因素包括管饲、糖尿病和胃肠道不良反应。其中，逻辑回归分析表明管饲和糖尿病是 FN 的独立预测因素。
社区环境中头颈部癌症患者 FN 的发生率高于先前报道。接受肠内营养的患者和患有糖尿病的患者发生 FN 的风险较高。
