Nohara Yuki, Ono Shuko, Tanaka Masumi, Yoshinaga Yasuteru, Ito Toshikazu, Yamashita Shinichi, Iwasaki Akinori
Dept. of General Thoracic, Breast, Endocrine and Pediatric Surgery, Fukuoka University, Faculty of Medicine.
Gan To Kagaku Ryoho. 2020 Nov;47(11):1589-1591.
Febrile neutropenia(FN)is an adverse event associated with chemotherapy. Because well-maintained dose intensity improves survival rate, suppression of FN is important. While the incidence of FN has been recognized to be higher with docetaxel/cyclophosphamide(TC)therapy, it is generally considered lower with doxorubicin/cyclophosphamide(AC)therapy, and primary prophylaxis with granulocyte-colony stimulating factor(G-CSF)is not recommended. FN with AC therapy is commonly experienced in our daily practice. Thus, we retrospectively compared the incidence of FN with AC and TC therapies. We examined the data of 48 patients with primary breast cancer, consisting of 26 patients treated with AC and 22 patients with TC as perioperative chemotherapy-from January 2014 to September 2018-to determine the incidence of FN. FN was observed in 7/26 patients who received AC(26.9%)and 5/22 patients who received TC(22.7%). Excluding patients with primary prophylaxis with G-CSF, FN was observed in 7/23 patients(30.4%)who received AC and 5/18 (27.8%)who received TC. The incidence of FN with AC therapy was higher than that with TC therapy in this study. Therefore, positive use of G-CSF is necessary for safety and to adequately maintain dose intensity for AC therapy.
发热性中性粒细胞减少症（FN）是一种与化疗相关的不良事件。由于维持良好的剂量强度可提高生存率，因此抑制FN很重要。虽然已认识到多西他赛/环磷酰胺（TC）治疗的FN发生率较高，但一般认为阿霉素/环磷酰胺（AC）治疗的FN发生率较低，不建议使用粒细胞集落刺激因子（G-CSF）进行一级预防。在我们的日常实践中，AC治疗的FN很常见。因此，我们回顾性比较了AC和TC治疗中FN的发生率。我们检查了48例原发性乳腺癌患者的数据，其中26例接受AC治疗，22例接受TC作为围手术期化疗（2014年1月至2018年9月），以确定FN的发生率。在接受AC治疗的26例患者中有7例（26.9%）观察到FN，在接受TC治疗的22例患者中有5例（22.7%）观察到FN。排除接受G-CSF一级预防的患者后，在接受AC治疗的23例患者中有7例（30.4%）观察到FN，在接受TC治疗的18例患者中有5例（27.8%）观察到FN。本研究中AC治疗的FN发生率高于TC治疗。因此，为了安全起见并充分维持AC治疗的剂量强度，积极使用G-CSF是必要的。
