Febrilna nevtropenija in nevtropenija višje stopnje ob adjuvantnem zdravljenju nedrobnoceličnega raka pljuč v vsakodnevni praksi

Based on clinical trial data, platinum-based adjuvant chemotherapy (Cht) is an intermediate risk factor for febrile neutropenia in patients with operable non-small-cell lung cancer (NSCLC). This study aims to assess the incidence of febrile neutropenia (FN) and high-grade neutropenia (G 3/4 N) in a group of patients treated in everyday clinical practice, and to determine the groups of patients that are at high risk of developing FN and G 3/4 N. Methods: This observational cohort study included 150 consecutive patient treatments with adjuvant Cht at the University Clinic Golnik, from January 2010 to May 2016. Complete blood counts ware taken on day 1 and day 8 of each cycle, and during each cycle of Cht if clinically indicated. Primary prophylaxis with G-CSF was used based on physician%s decision. The patients and treatment characteristics were collected from the hospital registry data. The average number of Cht cycles was 3.7 (range 1-4). To assess the risk factors, a logistic regression analysis was conducted. Results: Only 6/150 (4%) patients developed FN and 43/150 (29%) patients developed G 3/4 N. None of these patients received primary prophylaxis with G-CSF. Out of the nine risk factors assessed (age, gender, histologic type, stage, performance status, presence of comorbidities, type of surgery, Cht regimen, and year of treatment) only the year of treatment (before/after 2013) appeared to be a significant predictor of FN plus G 3/4 N incidence in the regression model. However, inspecting the frequency table indicates a tendency for higher incidence of FN in the subgroups of patients with pneumonectomy, higher PS, and in those receiving carboplatin. Conclusion: The incidence of FN and G 3/4 N during platinum- -based adjuvant Cht for NSCLC in our daily practice is comparable to the incidence reported in clinical studies. According to our observation, it seems that patients with pneumonectomy, higher performance status, and those receiving carboplatin are those who would benefit most from primary prophylaxis with G-CSF. The decline of FN and G 3/4 N incidence in the second treatment period (after the year 2013) is probably reflecting a more adequate usage of primary prophylaxis with G-CSF at our clinic.