Fujiwara Takumi, Kenmotsu Hirotsugu, Naito Tateaki, Kawamura Takahisa, Mamesaya Nobuaki, Kotake Mie, Kobayashi Haruki, Omori Shota, Nakashima Kazuhisa, Wakuda Kazushige, Ono Akira, Taira Tetsuhiko, Murakami Haruyasu, Omae Katsuhiro, Mori Keita, Endo Masahiro, Takahashi Toshiaki
Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Suntou-gun, Shizuoka, 411-8777, Japan.
Division of Respiratory Medicine, Minami Kyusyu National Hospital, 1882 Kida, Kajiki-cho, Aira-shi, Kagoshima, 899-5241, Japan.
Cancer Chemother Pharmacol. 2017 Jun;79(6):1229-1237. doi: 10.1007/s00280-017-3324-7. Epub 2017 Apr 28.
This study was to determine the incidence and risk factors of febrile neutropenia in chemotherapy-naïve Japanese patients treated systemically with etoposide plus platinum for lung cancer.
The study was a retrospective analysis of 244 patients who were monitored for febrile neutropenia through multiple cycles of the combination of etoposide with platinum, and the associations between incidence of febrile neutropenia and patient characteristics were evaluated.
Eighty-eight patients were treated with etoposide plus cisplatin and 156 were treated with etoposide plus carboplatin. Of the 244 patients treated, 198 (81.1%) completed 4 cycles for chemotherapy. Febrile neutropenia was observed in 48 of 244 patients (19.7%), including 18 of 88 (20.5%) patients who received etoposide plus cisplatin and 30 of 156 (19.2%) patients who received etoposide plus carboplatin. Grade 3 or 4 of neutropenia was experienced by a total of 208 patients (85.2%); 79 of 88 (89.8%) receiving etoposide plus cisplatin and 129 of 156 (82.7%) receiving etoposide plus carboplatin. Male gender and previous radiotherapy were identified by multivariate analysis as independent risk factors for febrile neutropenia.
These results contrast with findings in Western patients and suggest that ethnic differences exist in the incidence of febrile neutropenia in patients receiving etoposide plus platinum chemotherapy. In addition, our results suggest that primary prophylaxis with granulocyte colony-stimulating factor should be considered for patients with these risk factors for febrile neutropenia prior to treatment with etoposide plus platinum.
本研究旨在确定在日本初治肺癌患者中，接受依托泊苷联合铂类全身治疗时发热性中性粒细胞减少症的发生率及危险因素。
本研究对244例患者进行回顾性分析，这些患者在接受依托泊苷与铂类联合的多个化疗周期中接受了发热性中性粒细胞减少症监测，并评估了发热性中性粒细胞减少症发生率与患者特征之间的关联。
88例患者接受依托泊苷联合顺铂治疗，156例患者接受依托泊苷联合卡铂治疗。在接受治疗的244例患者中，198例（81.1%）完成了4个化疗周期。244例患者中有48例（19.7%）出现发热性中性粒细胞减少症，其中接受依托泊苷联合顺铂治疗的88例患者中有18例（20.5%），接受依托泊苷联合卡铂治疗的156例患者中有30例（19.2%）。共有208例患者（85.2%）经历了3级或4级中性粒细胞减少；接受依托泊苷联合顺铂治疗的88例患者中有79例（89.8%），接受依托泊苷联合卡铂治疗的156例患者中有129例（82.7%）。多因素分析确定男性和既往放疗是发热性中性粒细胞减少症的独立危险因素。
这些结果与西方患者的研究结果不同，提示接受依托泊苷联合铂类化疗的患者中，发热性中性粒细胞减少症的发生率存在种族差异。此外，我们的结果表明，对于有这些发热性中性粒细胞减少症危险因素的患者，在接受依托泊苷联合铂类治疗前，应考虑使用粒细胞集落刺激因子进行一级预防。
