Source: Annual Congress 2009 - Treatment of lung cancer
Disease area: Thoracic oncology

Abstract

Introduction
Febrile neutropenia (FN) is one of the major concerns in lung cancer patients treated with chemotherapy.
Aim
To study the number of chemotherapy induced grade 3 and 4 neutropenia, according to the National Cancer Institute Common Toxicity Criteria.
Methods
We prospectively collected the total blood count from patients receiving chemotherapy for small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC).
Patients received antibiotics in case of fever. Granulocyte-Colony Stimulating Factor (G-CSF) was given in case of delay because of pre-treatment neutropenia, need of dose reduction because of neutropenia or febrile neutropenia with sepsis.
Results
Data from 92 patients were analysed. Twenty-four patients had SCLC and 68 patients had NSCLC. In total 276 chemotherapy cycles were given. One patient died of FN. Twenty-one patients received G-CSF.

	Neutropenia grade 3/4 %	FN %
Our data:Docetaxel(D) Carboplatin(Cb)	39°	3°
Millward et al¹ D Cb	70°	7°
Our data:Gemcitabine(G) Cisplatin(Cp)	21·	2·
Cardenal et al² G Cp	64·	7·
Our data:Cisplatin(Cp) Etoposide(E)	78·	19·
Cardenal et al²	76·	12·
Our data:all regimes	48·	9·

°% of cycles ·% of patients ¹Annals of Oncology 2003;14:449-454 ²Journal of Clinical Oncology 1999;17:12-18

Conclusion
In our population of lung cancer patients chemotherapy related FN and mortality was significantly lower compared to the available literature, except for the Cp-E regime. These differences may be due to the introduction of G-CSF, the use of antibiotics, slightly different chemotherapeutic regimes and differences in patient characteristics. We consider to extend the use of G-CSF in the Cp-E regime.

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Citations should be made in the following way:
H. Peek, M. van der Vegt, J. Janssen, Y. Berk (Nijmegen, Netherlands). Chemotherapy induced neutropenia in lung cancer patients: a single centre study. Eur Respir J 2009; 34: Suppl. 53, 2647

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