Ishikawa Takashi, Sakamaki Kentaro, Narui Kazutaka, Kaise Hiroshi, Tsugawa Koichiro, Ichikawa Yasushi, Mukai Hirofumi
Department of Breast Surgery, Tokyo Medical University, Tokyo, Japan
Department of Biostatistics, Yokohama City University Medical Center, Yokohama, Japan.
Jpn J Clin Oncol. 2016 Jul;46(7):692-5. doi: 10.1093/jjco/hyw045. Epub 2016 May 9.
With the increasing use of adjuvant chemotherapy for treating early breast cancer, febrile neutropenia management has become crucial. Guidelines for febrile neutropenia management are mostly based on a Caucasian population survey although ethnic differences are reported in terms of adverse events. We survey the current status of febrile neutropenia and risk factors in Japanese female breast cancer patients receiving neoadjuvant and adjuvant chemotherapy regimens potential for febrile neutropenia. Subsequently, we plan to conduct a multicenter prospective cohort study involving 1000 patients with operable breast cancer. With the current state of oral antibiotics being routinely prescribed without hematology tests, we survey febrile neutropenia based on two different definitions, namely, true febrile neutropenia: ≥37.5°C and Grade 4 neutropenia, and surrogate febrile neutropenia: ≥37.5°C and oral antibiotic and antipyretic intake. The comparison of true febrile neutropenia and surrogate febrile neutropenia incidences is anticipated to provide information on the safety and feasibility of chemotherapy management without performing blood tests.
随着辅助化疗在早期乳腺癌治疗中的应用日益增加,发热性中性粒细胞减少症的管理变得至关重要。尽管在不良事件方面存在种族差异,但发热性中性粒细胞减少症的管理指南大多基于白种人群体调查。我们调查了接受新辅助和辅助化疗方案的日本女性乳腺癌患者中发热性中性粒细胞减少症的现状以及发生发热性中性粒细胞减少症的风险因素。随后,我们计划开展一项涉及1000例可手术乳腺癌患者的多中心前瞻性队列研究。鉴于目前在未进行血液学检查的情况下常规开具口服抗生素的现状,我们基于两种不同定义对发热性中性粒细胞减少症进行调查,即真性发热性中性粒细胞减少症:体温≥37.5°C且中性粒细胞减少症为4级,以及替代性发热性中性粒细胞减少症:体温≥37.5°C且服用口服抗生素和解热药物。预计真性发热性中性粒细胞减少症和替代性发热性中性粒细胞减少症发生率的比较将为不进行血液检查的化疗管理的安全性和可行性提供信息。