Evaluation of outpatient infections in lung cancer patients treated with chemotherapy and/or radiotherapy

Introduction: Infections are important causes of morbidity and mortality in lung cancer patients. The myelotoxicity caused by the administration of either the chemotherapeutic regimens or the radiotherapy increases the risk of potentially life-threatening infection. Methods: This prospective study included all patients with lung cancer who referred with signs or symptoms of infection between September 2009 and October 2011. Data concerning patient9s history, disease9s diagnosis, management and therapy and infection9s signs, symptoms and documentation were collected. Results: Seventy one patients with lung cancer were enrolled with febrile episodes and/or microbiologically or otherwise documented infection. Forty six patients (64.8%) presented with non-small cell lung carcinoma, while 22/71 patients (31%) and 3/71 patients (4.2%) had small cell lung cancer and mesothelioma respectively. Fifteen patients (21.1%) presented with FN and totally 43/71 (60.6%) patients required hospitalization for parenteral therapy upon admission. The predominant site of the infections was the lung in 59/71 patients (83.1%). In the hospitalized setting 3 episodes of bacteremia with Staphylococcus aureus were reported and microbiologically documented infections accounted for 26.7% of the hospitalized patients. The overall mortality rate was 9.8%, while only 1 patient died in the outpatient setting despite the antibiotic therapy. Conclusion: This study showed that the early detection and control of infection in lung cancer patients receiving therapy may improve their survival. Recognition of predisposing factors for infections and possible therapy toxicities should be evaluated carefully.