Kimura Kosei, Tanaka Satoru, Iwamoto Mitsuhiko, Fujioka Hiroya, Sato Nayuko, Terasawa Risa, Kawaguchi Kanako, Matsuda Junna, Umezaki Nodoka, Uchiyama Kazuhisa
Department of Breast and Endocrine Surgery, Osaka Medical College Hospital, Takatsuki, Osaka 569-8686, Japan.
Department of Breast Surgery, National Hospital Organization Osaka-Minami Medical Center, Kawachinagano, Osaka 586-8521, Japan.
Mol Clin Oncol. 2016 Oct;5(4):385-390. doi: 10.3892/mco.2016.992. Epub 2016 Aug 12.
The purpose of this study was to retrospectively analyze the feasibility of outpatient management without initial assessment for febrile patients undergoing adjuvant chemotherapy for breast cancer. A total of 131 consecutive patients with breast cancer treated with adjuvant or neoadjuvant chemotherapy from 2011 to 2013 at Osaka Medical College Hospital (Osaka, Japan) were retrospectively reviewed. In the case of developing a fever (body temperature, ≥38°C), the outpatients had been instructed to take previously prescribed oral antibiotics for 3 days without any initial assessment, and if no improvement had occurred by then, they were required to visit the hospital for examination and to undergo treatment based on the results of a risk assessment for complications. The primary aim of the present study was to assess the outcome of febrile episodes, while the secondary aim was to assess the incidence of febrile episodes, hospitalizations, and the type of chemotherapy. The 131 patients received 840 chemotherapy administrations. Fifty-five patients (42.0%) had a total of 75 febrile episodes after 840 chemotherapy administrations (8.9%). Treatment failure occurred in 12 of the 75 episodes (16.0%) in 11 of the 55 patients (20.0%). Only four episodes required hospitalization. Treatment success was achieved in 63 episodes (84.0%). In conclusion, the feasibility of outpatient management without initial assessment was evaluated in the present study for febrile patients undergoing adjuvant chemotherapy for breast cancer, and the outpatient strategy regimen may be safe and convenient for these patients.
本研究的目的是回顾性分析对接受乳腺癌辅助化疗的发热患者不进行初始评估而进行门诊管理的可行性。对2011年至2013年在日本大阪医学院附属医院（大阪）接受辅助或新辅助化疗的131例连续乳腺癌患者进行了回顾性研究。对于出现发热（体温≥38°C）的门诊患者，在没有任何初始评估的情况下，已指示他们服用先前开具的口服抗生素3天，如果届时没有改善，则要求他们到医院就诊并根据并发症风险评估结果接受治疗。本研究的主要目的是评估发热事件的结果，次要目的是评估发热事件的发生率、住院率和化疗类型。这131例患者共接受了840次化疗给药。55例患者（42.0%）在840次化疗给药后共出现75次发热事件（8.9%）。75次事件中有12次（16.0%）治疗失败，发生在55例患者中的11例（20.0%）。只有4次事件需要住院治疗。63次事件（84.0%）治疗成功。总之，本研究评估了对接受乳腺癌辅助化疗的发热患者不进行初始评估而进行门诊管理的可行性，门诊策略方案对这些患者可能是安全且方便的。
