Zhang Weiping, Sun Yongchen, Li Yiming
Department of Oncology, First People's Hospital of Shangqiu City Shangqiu 476100, Henan, China.
Department of Radiotherapy, First People's Hospital of Shangqiu City Shangqiu 476100, Henan, China.
Am J Cancer Res. 2025 Mar 15;15(3):1020-1035. doi: 10.62347/JRMG1142. eCollection 2025.
Small cell lung cancer (SCLC) is a rapidly proliferating malignancy with a poor prognosis, commonly treated with concurrent chemoradiotherapy based on the etoposide and cisplatin (EP) regimen; however, this treatment is often complicated by febrile neutropenia (FN), a potentially life-threatening condition that can compromise treatment efficacy and patient safety. The aim of this study was to identify risk factors for FN in SCLC patients undergoing EP-based concurrent chemoradiotherapy to enhance treatment outcomes and improve patient management. In this retrospective case-control study, data from 216 SCLC patients who underwent concurrent chemoradiotherapy with the EP regimen between September 2014 and January 2020 were analyzed. Patients were categorized into FN (n = 106) and non-FN (n = 110) groups. Various clinical factors, including body mass index (BMI), Eastern Cooperative Oncology Group Performance Status (ECOG PS), and pre-treatment laboratory values such as albumin, IL-6, and C-reactive protein (CRP), were examined. Statistical analyses, including univariate and multivariate logistic regression, were performed to identify independent risk factors for FN. Lower BMI ( = 0.016) and poorer ECOG Performance Status ( = 0.001) were associated with an increased risk of FN. Additionally, pre-albumin levels ( = 0.010), inflammatory markers CRP ( = 0.032), and IL-6 ( = 0.001) also showed significant associations, suggesting that nutritional status and systemic inflammation play important roles in the development of FN. Importantly, multivariate logistic regression analysis confirmed pre-albumin levels ( = 0.003), IL-6 level ( = 0.001), MASCC score ( < 0.001), and ECOG PS ( = 0.019) as independent factors for FN risk. These findings highlight the importance of nutritional status, systemic inflammation, and overall health condition in predicting FN occurrence, underscoring the need for integrated risk assessment and management strategies to mitigate FN risk in SCLC patients undergoing EP-based concurrent chemoradiotherapy.
小细胞肺癌（SCLC）是一种增殖迅速的恶性肿瘤，预后较差，通常采用依托泊苷和顺铂（EP）方案进行同步放化疗；然而，这种治疗常并发发热性中性粒细胞减少症（FN），这是一种可能危及生命的情况，会影响治疗效果和患者安全。本研究的目的是确定接受基于EP方案的同步放化疗的SCLC患者发生FN的危险因素，以提高治疗效果并改善患者管理。在这项回顾性病例对照研究中，分析了2014年9月至2020年1月期间216例接受EP方案同步放化疗的SCLC患者的数据。患者被分为FN组（n = 106）和非FN组（n = 110）。检查了各种临床因素，包括体重指数（BMI）、东部肿瘤协作组体能状态（ECOG PS）以及治疗前实验室值，如白蛋白、白细胞介素-6（IL-6）和C反应蛋白（CRP）。进行了包括单因素和多因素逻辑回归在内的统计分析，以确定FN的独立危险因素。较低的BMI（P = 0.016）和较差的ECOG体能状态（P = 0.001）与FN风险增加相关。此外，前白蛋白水平（P = 0.010）、炎症标志物CRP（P = 0.032）和IL-6（P = 0.001）也显示出显著相关性，表明营养状况和全身炎症在FN的发生中起重要作用。重要的是，多因素逻辑回归分析确认前白蛋白水平（P = 0.003）、IL-6水平（P = 0.001）、MASCC评分（P < 0.001）和ECOG PS（P = 0.019）是FN风险的独立因素。这些发现凸显了营养状况、全身炎症和整体健康状况在预测FN发生中的重要性，强调了需要综合风险评估和管理策略来降低接受基于EP方案同步放化疗的SCLC患者的FN风险。
