FOLFIRINOX in Pancreatic Cancer: Risk Factors for Febrile Neutropenia and Severe Neutropenia - Nationwide Study Analysis.

Autor:	Todaka A; Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan; a.todaka@scchr.jp., Sasaki M; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan.; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Chiba, Japan., Ueno H; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan., Goto T; Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Hokkaido, Japan., Murohisa G; Department of Gastroenterology, Seirei Hamamatsu General Hospital, Shizuoka, Japan., Mizuno N; Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan., Ozaka M; Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan., Kobayashi S; Department of Gastroenterology, Kanagawa Cancer Center, Kanagawa, Japan., Uesugi K; Department of Gastroenterology, National Hospital Organization Shikoku Cancer Center, Ehime, Japan., Kobayashi N; Department of Oncology, Yokohama City University Hospital, Kanagawa, Japan., Hayashi H; Department of Gastroenterology and Hepatology, Hokkaido University, Hokkaido, Japan., Sudo K; Department of Gastroenterology, Chiba Cancer Center, Chiba, Japan., Okano N; Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan., Horita Y; Department of Chemotherapy and Internal Medicine, Toyama Prefectural Central Hospital, Toyama, Japan., Kamei K; Department of Surgery, Kindai University Faculty of Medicine, Osaka, Japan., Nanami S; The Mt. Fuji Foundation for Healthcare Innovation and Cluster Development, Shizuoka, Japan., Boku N; Department of Oncology and General Medicine, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
Jazyk:	angličtina
Zdroj:	Anticancer research [Anticancer Res] 2023 Sep; Vol. 43 (9), pp. 4115-4123.
DOI:	10.21873/anticanres.16601
Abstrakt:	Background/aim: FOLFIRINOX (FFX) is a standard treatment for patients with advanced pancreatic cancer. However, it often causes serious hematological adverse events. This study aimed to identify the risk factors for febrile neutropenia (FN) and grade 4 (G4) neutropenia during treatment with FFX in the real world. Patients and Methods: We analyzed data obtained from a nationwide multicenter observational study (JASPAC 06) that included 399 patients with unresectable or recurrent pancreatic cancer who received FFX at 27 institutions in Japan. Results: Nadir neutrophil counts occurred from day 8 to day 22 of cycle 1, and granulocyte colony-stimulating factor was administered to over a quarter of the patients in the first cycle. Of 399 patients, FN and G4 neutropenia occurred in 51 (13%) and 108 (27%) patients, respectively. Most FN (83%) and G4 neutropenia (75%) occurred in the first or second cycles. Multivariate logistic regression analyses showed that total bilirubin (TB) > the upper limit of normal range (ULN) and no dose modification from the original regimen were significantly associated with FN, and that TB > ULN, no dose modification from the original regimen, low platelet count (<15×10 4 /μl), and recurrent disease after pancreatectomy were independent risk factors for G4 neutropenia. Conclusion: No dose modification from the original regimen and TB > ULN were risk factors for FN and G4 neutropenia. (Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)
Databáze:	MEDLINE
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