Incidence and predictors of febrile neutropenia during chemotherapy in patients with head and neck cancer.
Incidence and predictors of febrile neutropenia during chemotherapy in patients with head and neck cancer.
复制标题
头颈癌患者化疗期间发热性中性粒细胞减少症的发生率和预测因素。
DOI：
10.1007/s00520-013-1873-9
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发表时间：
2013
影响因子：
3.1
通讯作者：
Inohara H.
中科院分区：
文献类型：
--
作者：
Takenaka Y;Cho H;Yamamoto M;Nakahara S;Yamamoto Y;Inohara H.
目的发热性中性粒细胞减少症（FN）是一种肿瘤急症，其治疗在化疗中至关重要。然而，人们对头颈癌患者的FN知之甚少。本研究的目的是探讨头颈癌患者FN的发生率和预测因素。方法2008年1月至2012年12月在日本某大学医院进行回顾性研究。用铂类药物治疗的头颈癌患者也被纳入分析。结果138个周期中有47个周期发生FN，其中第1个周期FN发生率最高。在46%的FN发作中观察到严重败血症或更严重的事件。接受TPF（多西紫杉醇、顺铂和氟尿嘧啶）治疗的患者比接受DC（多西紫杉醇、顺铂）治疗的患者更容易发生FN。单因素分析显示，患者特有的危险因素为管饲、糖尿病的存在和胃肠道不良反应。其中，logistic回归分析显示管饲和糖尿病是FN的独立预测因素。结论社区头颈癌患者FN发生率高于既往报道。接受肠内营养的患者和糖尿病患者是FN的高危人群。
PurposeFebrile neutropenia (FN) is an oncologic emergency, and its management is critical during chemotherapy. However, little is known about FN in patients with head and neck cancer. The purpose of this study was to investigate the incidence and predictors of FN in patients with head and neck cancer.MethodsWe performed a retrospective study in a university hospital in Japan between January 2008 and December 2012. Head and neck cancer patients treated with a platinum-based regimen were included in the analysis.ResultsFN occurred in 47 out of 138 cycles, and the incidence of FN was highest during the first cycle. Severe sepsis or more serious events were observed in 46 % of FN episodes. Patients treated with TPF (docetaxel, cisplatin, and fluorouracil) were more susceptible to FN than those treated with DC (docetaxel, cisplatin). The patient-specific risk factors revealed using univariate analysis were tube feeding, the presence of diabetes mellitus, and gastrointestinal adverse effects. Of these, logistic regression analysis demonstrated tube feeding and diabetes mellitus as independent predictors of FN.ConclusionsThe incidence of FN in head and neck cancer patients in the community setting is higher than previously reported. Patients receiving enteral nutrition and those with diabetes are at high risk for FN.