Vol.62 No.3 May 2014

Investigation of the management and risk of febrile neutropenia associated with chemotherapy in the urological field: a multicenter, retrospective analysis

Koichiro Wada^1,11), Ryuta Tanimoto¹⁾, Hiroyuki Nose^1,11), Shinya Uehara^1,11), Toyohiko Watanabe^1,11), Hiroshi Hayami^2,11), Shingo Nagai^3,11), Mitsuru Yasuda^3,11), Takashi Deguchi^3,11), Keisuke Shigeta⁴⁾, Satoshi Yazawa^4,11), Eiji Kikuchi⁴⁾, Mototsugu Oya^4,11), Jiro Hashimoto^5,11), Teruhisa Uehara^5,11), Yuichiro Kurimura^5,11), Yoshiki Hiyama^5,11), Satoshi Takahashi^5,11), Taiji Tsukamoto^5,11), Takehiko Sho^6,11), Ryoichi Hamasuna^6,11), Jun Miyazaki^7,11), Yoshikazu Togo^8,11), Rikiya Taoka^8,11), Atsushi Nakao^8,11), Shingo Yamamoto^8,11), Kanao Kobayashi^9,11), Akio Matsubara^9,11), Kiyohito Ishikawa^10,11), Hiromi Kumon^1,11) and Tetsuro Matsumoto^6,11)

¹⁾Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Japan
²⁾Blood Purification Center, Kagoshima University Hospital
³⁾Department of Urology, Gifu University Graduate School of Medicine
⁴⁾Department of Urology, Keio University School of Medicine
⁵⁾Department of Urology, Sapporo Medical University School of Medicine
⁶⁾Department of Urology, University of Occupational and Environmental Health, Japan
⁷⁾Department of Urology, Faculty of Medicine, University of Tsukuba
⁸⁾Department of Urology, Hyogo College of Medicine
⁹⁾Department of Urology, Institute of Biomedical & Health Sciences, Hiroshima University
¹⁰⁾Department of Urology, Fujita Health University School of Medicine
¹¹⁾Japanese Society of Urinary Tract Infection Cooperative Study Group

Abstract

In Japan, chemotherapy for urogenital malignant diseases is commonly performed by urologists and febrile neutropenia (FN) is one of the major adverse events associated with chemotherapy, however, few reports exist from the urological field about FN. In this present study, a total of 883 courses of chemotherapy (326 patients) performed from 2010 to 2011 at 10 University Hospitals were retrospectively reviewed. The regimens were GC (gemcitabine and cisplatin), GCP (gemcitabine, cisplatin and paclitaxel) and M-VAC (methotrexate, vinblastine, doxorubicin, cisplatin) for urothelial carcinoma, and EP (etoposide and cisplatin) and BEP (bleomycin, etoposide and cisplatin) for testicular cancer. In 81 courses (9.2%, 66 patients; 20.2%) including FN, antimicrobials and granulocyte-colony stimulating factor(G-CSF) were administered in 69 courses (85.2%) and in 77 courses (95.1%), respectively. The MASCC risk-index score was evaluated in no more than 51 courses (63.0%) and 1 patient with 18 points on the MASCC score died due to myelotoxicity and infections. According to statistical investigations, FN is significantly more frequent in GCP and M-VAC than in GC (p=0.0073, < 0.0001) and in a similar manner in BEP than in EP (p=0.0405). In patients with afebrile neutropenia (AN), observed in 232 courses (26.3%), antimicrobials and G-CSF were administered in 5 courses (2.2%) and in 144 courses (62.1%), respectively. Further evidence from the urological field is required to investigate the treatment and risk of FN for management of patients with urogenital malignancies.

Key word

anticancer chemotherapy, febrile neutropenia, urology, multicenter trial

Received

January 9, 2014

Accepted

March 4, 2014

Jpn. J. Chemother. 62 (3): 374-381, 2014