Risk factors of febrile neutropenia induced by chemotherapy in lung cancer patients

Abstract

Introduction Febrile neutropenia (FN) is one of the life threatening complications in cancer patients undergoing chemotherapy. Several comorbidities that are related to chronic inflammation, such as chronic obstructive pulmonary disease (COPD), cholecystolithiasis and dental caries, may influence the risk of FN, but few reports are available on these correlations.

Aims To assess the risk factors of chemotherapy-induced FN in lung cancer patients, we respectively analyzed the correlation between the incidence of FN and chronic comorbidities.

Methods This study was a retrospective analysis of lung cancer patients treated with systemic chemotherapy at University of miyazaki hospital between April 2010 and December 2015. The history of comorbidities and FN events were identified using electronic medical records. The definition of FN was used the criteria of CTCAE (ver. 4.0).

Results This study was conducted with 270 patients (mean age of 65.2±9.4 years) as the subject. 46 cases (17%) developed FN for the duration of chemotherapy. The histological types of lung cancer were small cell lung cancer (n = 77), adenocarcinoma (n = 122), squamous cell carcinoma (n = 41), and other types (n = 30). COPD [odds ratio (OR) = 2.5, 95%Confidence interval (CI) = 1.16–5.38, p = 0.02) was associated with a significantly increased FN risk. Cholecystolithiasis [OR = 1.47, 95%CI = 0.32–6.68, p = 0.61], sinusitis [OR = 1.03, 95%CI = 0.29–3.71, p = 1.00], constipation [OR = 1.47, 95%CI = 0.32–6.68, p = 0.61] and dental caries [OR = 1.17, 95%CI = 0.43–3.21, p = 1.00] had no significant association with FN.

Conclusions COPD is reliable predictor to evaluate risk of chemotherapy-induced FN in the lung cancer patients.