Febrile neutropenia and its associated hospitalization in breast cancer patients on docetaxel-containing regimen: A retrospective cohort study on duration of prophylactic GCSF administration.

Autor: Lee CF; School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong. jeff.travailler@gmail.com.; Department of Pharmacy, Tuen Mun Hospital, Tuen Mun, Hong Kong. jeff.travailler@gmail.com., Zhou K; School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong., Young WM; Department of Pharmacy, Tuen Mun Hospital, Tuen Mun, Hong Kong.; COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong., Wong CS; Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong., Ng TY; Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong., Lee SF; Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong., Leung K; COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong.; Department of Pharmacy, Queen Mary Hospital, Pok Fu Lam, Hong Kong., Wong LKM; COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong.; Department of Pharmacy, Queen Elizabeth Hospital, Kowloon, Hong Kong., So KH; COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong.; Department of Pharmacy, Prince of Wales Hospital, Sha Tin, Hong Kong., Tang W; COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong.; Department of Pharmacy, United Christian Hospital, Kwun Tong, Hong Kong., Chong G; COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong.; Department of Pharmacy, United Christian Hospital, Kwun Tong, Hong Kong., Chan SK; Department of Pharmacy, Princess Margaret Hospital, Kwai Chung, Hong Kong., Yip YTE; COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong.; Department of Pharmacy, Princess Margaret Hospital, Kwai Chung, Hong Kong., Ma VYM; COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong.; Department of Pharmacy, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong., Yeung A; Department of Pharmacy, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong., Chin CHY; Department of Pharmacy, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong., Kwan MW; Department of Pharmacy, Queen Elizabeth Hospital, Kowloon, Hong Kong., Tsang HT; Department of Pharmacy, Queen Elizabeth Hospital, Kowloon, Hong Kong.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2020 Aug; Vol. 28 (8), pp. 3801-3812. Date of Electronic Publication: 2019 Dec 12.
DOI: 10.1007/s00520-019-05111-6
Abstrakt: Purpose: To compare febrile neutropenia (FN) incidence and hospitalization among breast cancer patients on docetaxel with no granulocyte colony-stimulating factors (GCSF) primary prophylaxis (PP), 4/5-day PP, or 7-day PP.
Methods: We identified 3916 breast cancer patients using docetaxel-cyclophosphamide (TC), doxorubicin-cyclophosphamide then docetaxel (AC-T), fluorouracil-epirubicin-cyclophosphamide then docetaxel (FEC-T), docetaxel-carboplatin-trastuzumab (TJH), or docetaxel-doxorubicin-cyclophosphamide (TAC) from a hospital pharmacy dispensing database in Hong Kong between 2014 and 2016. Patients were offered GCSF within 5 days since administering docetaxel. Outcomes included FN incidence, time to first hospitalization, hospitalization rate, and duration.
Results: In TC regimen, FN incidence (with odds ratio, OR) of patients with no PP, 4/5-day PP, and 7-day PP was 21.69%, 7.95% (OR 0.31, p < 0.001), and 5.33% (OR 0.20, p < 0.001), respectively. In TJH regimen, FN incidence of patients with no PP, 4/5-day PP, and 7-day PP was 38.26%, 8.33% (OR 0.15, p < 0.001), and 8.57% (OR 0.15, p < 0.001), respectively. FN incidence of patients on AC-T regimen with no PP and 4/5-day PP was 20.93% and 6.84%, respectively (OR 0.28, p = 0.005); with FEC-T regimen, the incidence was 9.91% and 4.77%, respectively (OR 0.46, p = 0.035). Only 3.27% FN cases were not hospitalized. Mean (±standard deviation, SD) time to first hospitalization was 8.21 ± 2.44 days. Mean (±SD) duration of hospitalization for patients with no PP, 4/5-day PP, and 7-day PP was 4.66 ± 2.60, 4.37 ± 2.85, and 5.12 ± 2.97 days, respectively.
Conclusion: GCSF prophylaxis in breast cancer patients on docetaxel could reduce FN incidence and hospitalization. 4/5-day PP demonstrated similar efficacy to 7-day PP with superior saving benefits on healthcare expenditure.
Databáze: MEDLINE
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