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Published in: Supportive Care in Cancer 10/2013

01-10-2013 | Original Article

Incidence and predictors of febrile neutropenia during chemotherapy in patients with head and neck cancer

Authors: Yukinori Takenaka, Hironori Cho, Masashi Yamamoto, Susumu Nakahara, Yoshifumi Yamamoto, Hidenori Inohara

Published in: Supportive Care in Cancer | Issue 10/2013

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Abstract

Purpose

Febrile 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.

Methods

We 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.

Results

FN 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.

Conclusions

The 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.
Literature
1.
go back to reference Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA, Raad II, Rolston KV, Young JA, Wingard JR, Infectious Diseases Society of America (2011) Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of America. Clin Infect Dis 52:56–93CrossRef Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA, Raad II, Rolston KV, Young JA, Wingard JR, Infectious Diseases Society of America (2011) Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of America. Clin Infect Dis 52:56–93CrossRef
2.
go back to reference Crawford J, Dale DC, Lyman GH (2004) Chemotherapy-induced neutropenia: risks, consequences, and new directions for its management. Cancer 100:228–237CrossRefPubMed Crawford J, Dale DC, Lyman GH (2004) Chemotherapy-induced neutropenia: risks, consequences, and new directions for its management. Cancer 100:228–237CrossRefPubMed
3.
go back to reference Aapro MS, Bohlius J, Cameron DA, Dal Lago L, Donnelly JP, Kearney N, Lyman GH, Pettengell R, Tjan-Heijnen VC, Walewski J, Weber DC, Zielinski C (2011) 2010 update of EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphoproliferative disorders and solid tumors. Eur J Cancer 47:8–32CrossRefPubMed Aapro MS, Bohlius J, Cameron DA, Dal Lago L, Donnelly JP, Kearney N, Lyman GH, Pettengell R, Tjan-Heijnen VC, Walewski J, Weber DC, Zielinski C (2011) 2010 update of EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphoproliferative disorders and solid tumors. Eur J Cancer 47:8–32CrossRefPubMed
4.
go back to reference Smith TJ, Khatcheressian J, Lyman GH, Ozer H, Armitage JO, Balducci L, Bennett CL, Cantor SB, Crawford J, Cross SJ, Demetri G, Desch CE, Pizzo PA, Schiffer CA, Schwartzberg L, Somerfield MR, Somlo G, Wade JC, Wade JL, Winn RJ, Wozniak AJ, Wolff AC (2006) 2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline. J Clin Oncol 24:3187–3205CrossRefPubMed Smith TJ, Khatcheressian J, Lyman GH, Ozer H, Armitage JO, Balducci L, Bennett CL, Cantor SB, Crawford J, Cross SJ, Demetri G, Desch CE, Pizzo PA, Schiffer CA, Schwartzberg L, Somerfield MR, Somlo G, Wade JC, Wade JL, Winn RJ, Wozniak AJ, Wolff AC (2006) 2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline. J Clin Oncol 24:3187–3205CrossRefPubMed
5.
go back to reference Posner MR, Hershock DM, Blajman CR, Mickiewicz E, Winquist E, Gorbounova V, Tjulandin S, Shin DM, Cullen K, Ervin TJ, Murphy BA, Raez LE, Cohen RB, Spaulding M, Tishler RB, Roth B, Viroglio Rdel C, Venkatesan V, Romanov I, Agarwala S, Harter KW, Dugan M, Cmelak A, Markoe AM, Read PW, Steinbrenner L, Colevas AD, Norris CM Jr, Haddad RI (2007) Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med 357:1705–1715CrossRefPubMed Posner MR, Hershock DM, Blajman CR, Mickiewicz E, Winquist E, Gorbounova V, Tjulandin S, Shin DM, Cullen K, Ervin TJ, Murphy BA, Raez LE, Cohen RB, Spaulding M, Tishler RB, Roth B, Viroglio Rdel C, Venkatesan V, Romanov I, Agarwala S, Harter KW, Dugan M, Cmelak A, Markoe AM, Read PW, Steinbrenner L, Colevas AD, Norris CM Jr, Haddad RI (2007) Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med 357:1705–1715CrossRefPubMed
6.
go back to reference Vermorken JB, Remenar E, van Herpen C, Gorlia T, Mesia R, Degardin M, Stewart JS, Jelic S, Betka J, Preiss JH, van den Weyngaert D, Awada A, Cupissol D, Kienzer HR, Rey A, Desaunois I, Bernier J, Lefebvre JL (2007) Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N Engl J Med 357:1695–1704CrossRefPubMed Vermorken JB, Remenar E, van Herpen C, Gorlia T, Mesia R, Degardin M, Stewart JS, Jelic S, Betka J, Preiss JH, van den Weyngaert D, Awada A, Cupissol D, Kienzer HR, Rey A, Desaunois I, Bernier J, Lefebvre JL (2007) Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N Engl J Med 357:1695–1704CrossRefPubMed
7.
go back to reference Baghi M, Hambek M, May A, Radeloff A, Gstoettner W, Knecht R (2006) Adjuvant docetaxel, cisplatin, and 5-fluorouracil (TPF) in locally advanced squamous cell carcinoma of the head and neck. Anticancer Res 26:559–563PubMed Baghi M, Hambek M, May A, Radeloff A, Gstoettner W, Knecht R (2006) Adjuvant docetaxel, cisplatin, and 5-fluorouracil (TPF) in locally advanced squamous cell carcinoma of the head and neck. Anticancer Res 26:559–563PubMed
8.
go back to reference Samlowski WE, Moon J, Kuebler JP, Nichols CR, Gandara DR, Ozer H, Williamson SK, Atkins JN, Schuller DE, Ensley JF (2007) Evaluation of the combination of docetaxel/carboplatin in patients with metastatic or recurrent squamous cell carcinoma of the head and neck (SCCHN): a Southwest oncology group phase II study. Cancer Invest 25:182–188CrossRefPubMed Samlowski WE, Moon J, Kuebler JP, Nichols CR, Gandara DR, Ozer H, Williamson SK, Atkins JN, Schuller DE, Ensley JF (2007) Evaluation of the combination of docetaxel/carboplatin in patients with metastatic or recurrent squamous cell carcinoma of the head and neck (SCCHN): a Southwest oncology group phase II study. Cancer Invest 25:182–188CrossRefPubMed
9.
go back to reference Masaoka T (2004) Evidence-based recommendations for antimicrobial use in febrile neutropenia in Japan: executive summary. Clin Infect Dis 39(Suppl 1):S49–52CrossRefPubMed Masaoka T (2004) Evidence-based recommendations for antimicrobial use in febrile neutropenia in Japan: executive summary. Clin Infect Dis 39(Suppl 1):S49–52CrossRefPubMed
10.
go back to reference Viscoli C, Castagnola E (2005) Prophylaxis and empirical therapy for infection in cancer patients. In: Mandell GL, Bennett JE, Doolin R (eds) Principles and practice of infectious diseases. Churchill Livingstone, Philadelphia, pp 3442–3462 Viscoli C, Castagnola E (2005) Prophylaxis and empirical therapy for infection in cancer patients. In: Mandell GL, Bennett JE, Doolin R (eds) Principles and practice of infectious diseases. Churchill Livingstone, Philadelphia, pp 3442–3462
11.
go back to reference Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM consensus conference committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 101:1644–1655CrossRefPubMed Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM consensus conference committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 101:1644–1655CrossRefPubMed
12.
go back to reference Kuderer NM, Dale DC, Crawford J, Lyman GH (2007) Impact of primary prophylaxis with granulocyte colony-stimulating factor on febrile neutropenia and mortality in adult cancer patients receiving chemotherapy: a systematic review. J Clin Oncol 25:3158–3167CrossRefPubMed Kuderer NM, Dale DC, Crawford J, Lyman GH (2007) Impact of primary prophylaxis with granulocyte colony-stimulating factor on febrile neutropenia and mortality in adult cancer patients receiving chemotherapy: a systematic review. J Clin Oncol 25:3158–3167CrossRefPubMed
13.
go back to reference Bucaneve G, Micozzi A, Menichetti F, Martino P, Dionisi MS, Martinelli G, Allione B, D’Antonio D, Buelli M, Nosari AM, Cilloni D, Zuffa E, Cantaffa R, Specchia G, Amadori S, Fabbiano F, Deliliers GL, Lauria F, Foa R, Del Favero A (2005) Levofloxacin to prevent bacterial infection in patients with cancer and neutropenia. N Engl J Med 353:977–987CrossRefPubMed Bucaneve G, Micozzi A, Menichetti F, Martino P, Dionisi MS, Martinelli G, Allione B, D’Antonio D, Buelli M, Nosari AM, Cilloni D, Zuffa E, Cantaffa R, Specchia G, Amadori S, Fabbiano F, Deliliers GL, Lauria F, Foa R, Del Favero A (2005) Levofloxacin to prevent bacterial infection in patients with cancer and neutropenia. N Engl J Med 353:977–987CrossRefPubMed
14.
go back to reference Cullen M, Steven N, Billingham L, Gaunt C, Hastings M, Simmonds P, Stuart N, Rea D, Bower M, Fernando I, Huddart R, Gollins S, Stanley A (2005) Antibacterial prophylaxis after chemotherapy for solid tumors and lymphomas. N Engl J Med 353:988–998CrossRefPubMed Cullen M, Steven N, Billingham L, Gaunt C, Hastings M, Simmonds P, Stuart N, Rea D, Bower M, Fernando I, Huddart R, Gollins S, Stanley A (2005) Antibacterial prophylaxis after chemotherapy for solid tumors and lymphomas. N Engl J Med 353:988–998CrossRefPubMed
15.
go back to reference Srokowski TP, Fang S, Hortobagyi GN, Giordano SH (2009) Impact of diabetes mellitus on complications and outcomes of adjuvant chemotherapy in older patients with breast cancer. J Clin Oncol 27:2170–2176CrossRefPubMed Srokowski TP, Fang S, Hortobagyi GN, Giordano SH (2009) Impact of diabetes mellitus on complications and outcomes of adjuvant chemotherapy in older patients with breast cancer. J Clin Oncol 27:2170–2176CrossRefPubMed
16.
go back to reference Rosenthal DI, Lewin JS, Eisbruch A (2006) Prevention and treatment of dysphagia and aspiration after chemoradiation for head and neck cancer. J Clin Oncol 24:2636–2643CrossRefPubMed Rosenthal DI, Lewin JS, Eisbruch A (2006) Prevention and treatment of dysphagia and aspiration after chemoradiation for head and neck cancer. J Clin Oncol 24:2636–2643CrossRefPubMed
17.
go back to reference Platteaux N, Dirix P, Dejaeger E, Nuyts S (2010) Dysphagia in head and neck cancer patients treated with chemoradiotherapy. Dysphagia 25:139–152CrossRefPubMed Platteaux N, Dirix P, Dejaeger E, Nuyts S (2010) Dysphagia in head and neck cancer patients treated with chemoradiotherapy. Dysphagia 25:139–152CrossRefPubMed
18.
go back to reference Short TP, Patel NR, Thomas E (1996) Prevalence of gastroesophageal reflux in patients who develop pneumonia following percutaneous endoscopic gastrostomy: a 24-h pH monitoring study. Dysphagia 11:87–89CrossRefPubMed Short TP, Patel NR, Thomas E (1996) Prevalence of gastroesophageal reflux in patients who develop pneumonia following percutaneous endoscopic gastrostomy: a 24-h pH monitoring study. Dysphagia 11:87–89CrossRefPubMed
19.
20.
go back to reference Khan SA, Wingard JR (2001) Infection and mucosal injury in cancer treatment. J Natl Cancer Inst Monogr: 31–36 Khan SA, Wingard JR (2001) Infection and mucosal injury in cancer treatment. J Natl Cancer Inst Monogr: 31–36
21.
go back to reference Blijlevens NM, Donnelly JP, de Pauw BE (2001) Empirical therapy of febrile neutropenic patients with mucositis: challenge of risk-based therapy. Clin Microbiol Infect 7(Suppl 4):47–52CrossRefPubMed Blijlevens NM, Donnelly JP, de Pauw BE (2001) Empirical therapy of febrile neutropenic patients with mucositis: challenge of risk-based therapy. Clin Microbiol Infect 7(Suppl 4):47–52CrossRefPubMed
22.
go back to reference Sonis ST, Elting LS, Keefe D, Peterson DE, Schubert M, Hauer-Jensen M, Bekele BN, Raber-Durlacher J, Donnelly JP, Rubenstein EB (2004) Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 100:1995–2025CrossRefPubMed Sonis ST, Elting LS, Keefe D, Peterson DE, Schubert M, Hauer-Jensen M, Bekele BN, Raber-Durlacher J, Donnelly JP, Rubenstein EB (2004) Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 100:1995–2025CrossRefPubMed
23.
go back to reference Stott-Miller M, Chen C, Chuang SC, Lee YC, Boccia S, Brenner H, Cadoni G, Dal Maso L, La Vecchia C, Lazarus P, Levi F, Matsuo K, Morgenstern H, Muller H, Muscat J, Olshan AF, Purdue MP, Serraino D, Vaughan TL, Zhang ZF, Boffetta P, Hashibe M, Schwartz SM (2012) History of diabetes and risk of head and neck cancer: a pooled analysis from the international head and neck cancer epidemiology consortium. Cancer Epidemiol Biomarkers Prev 21:294–304CrossRefPubMed Stott-Miller M, Chen C, Chuang SC, Lee YC, Boccia S, Brenner H, Cadoni G, Dal Maso L, La Vecchia C, Lazarus P, Levi F, Matsuo K, Morgenstern H, Muller H, Muscat J, Olshan AF, Purdue MP, Serraino D, Vaughan TL, Zhang ZF, Boffetta P, Hashibe M, Schwartz SM (2012) History of diabetes and risk of head and neck cancer: a pooled analysis from the international head and neck cancer epidemiology consortium. Cancer Epidemiol Biomarkers Prev 21:294–304CrossRefPubMed
24.
go back to reference Rajagopalan S (2005) Serious infections in elderly patients with diabetes mellitus. Clin Infect Dis 40:990–996CrossRefPubMed Rajagopalan S (2005) Serious infections in elderly patients with diabetes mellitus. Clin Infect Dis 40:990–996CrossRefPubMed
Metadata
Title
Incidence and predictors of febrile neutropenia during chemotherapy in patients with head and neck cancer
Authors
Yukinori Takenaka
Hironori Cho
Masashi Yamamoto
Susumu Nakahara
Yoshifumi Yamamoto
Hidenori Inohara
Publication date
01-10-2013
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 10/2013
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-013-1873-9

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