Risk Factors for Febrile Neutropenia Induced by Docetaxel Chemotherapy in Patients with Non-small Cell Lung Cancer
Risk Factors for Febrile Neutropenia Induced by Docetaxel Chemotherapy in Patients with Non-small Cell Lung Cancer
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DOI：
10.1248/bpb.b20-00266
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发表时间：
2020-08-01
影响因子：
2
通讯作者：
Nakamura, Tsutomu
中科院分区：
文献类型：
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作者：
Uchida, Mayako;Yamaguchi, Yuki;Nakamura, Tsutomu
我们回顾性地从医疗记录中获得患者背景和预处理特征的数据，并确定了多西他赛单独或联合抗血管内皮生长因子（VEGF）抗体贝伐单抗治疗的非小细胞肺癌（NSCLC）患者发热性中性粒细胞减少症（FN）的预测因素。2011年7月1日至2018年3月31日期间，在神户市医疗中心总医院呼吸内科接受多西他赛单药治疗或联合贝伐单抗治疗的20岁或以上的非小细胞肺癌患者有资格纳入研究。81例复发或晚期非小细胞肺癌患者纳入研究。多因素逐步logistic回归分析显示，东部肿瘤合作组绩效状态（ECOG-PS）评分1分和2分基线较低(优势比（OR）， 5.098；95%可信区间（CI） 1.045 ~ 24.879, p = 0.021)和基线血小板计数低于18.8 × 10(4)/pL （OR, 3.861; 95% CI, 1.211 ~ 12.311, p = 0.022）是影响FN发生率的显著因素。我们的研究结果表明，ecog - ps1 -2和较低的基线血小板计数是接受多西他赛化疗的NSCLC患者FN的重要危险因素。此外，抗vegf抗体联合多西他赛可能与FN频率增加有关。尽管本研究具有回顾性设计、单中心、小样本量等局限性，但基线ECOG-PS评分和血小板计数可作为多西他赛化疗前预防性粒细胞集落刺激因子（C-CSF）治疗患者的重要指标。
We retrospectively obtained data of patient background and pretreatment characteristics from medical records and identified the predictive factors of febrile neutropenia (FN) in patients with non-small cell lung cancer (NSCLC) treated with docetaxel alone or in combination with the anti-vascular endothelial growth factor (VEGF) antibody bevacizumab. Patients were eligible for inclusion in the study if they were 20 years or older, diagnosed with NSCLC, and received docetaxel monotherapy alone or in combination with bevacizumab at the Department of Respiratory Medicine, Kobe City Medical Center General Hospital, between July 1, 2011, and March 31, 2018. Eighty-one patients with recurrent or advanced NSCLC were included. Multivariate stepwise logistic regression analysis with backward selection revealed that lower baseline Eastern Cooperative Oncology Group performance status (ECOG-PS) scores of I and 2 (odds ratio (OR), 5.098; 95% confidence interval (CI), 1.045-24.879, p = 0.021) and baseline platelet count below 18.8 x 10(4)/pL (OR, 3.861; 95% CI, 1.211-12.311, p = 0.022) were significant factors influencing the FN occurrence rate. Our results demonstrated that ECOG-PS 1-2 and lower baseline platelet count were significant risk factors of FN in patients with NSCLC receiving docetaxel-based chemotherapy. Moreover, the combination of anti-VEGF antibodies and docetaxel might be associated with increased FN frequency. Despite the limitations of this study including its retrospective design, single-center site, and small sample size, baseline ECOG-PS score and platelet count may be regarded as important indices to identify patients for prophylactic granulocyte colony stimulating factor (C-CSF) treatment before docetaxel-based chemotherapy.