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Febrile neutropenia risk with adjuvant TC (docetaxel and cyclophosphamide) regimen: Experience of Brazilian cancer centers
Abstract   Peer reviewed

Febrile neutropenia risk with adjuvant TC (docetaxel and cyclophosphamide) regimen: Experience of Brazilian cancer centers

Joao Paulo Velloso Medrado Santos, Debora De Melo Gagliato, Rachel Jorge Dino Cossetti, Rodrigo Darouche Gimenez and Max S. Mano
Journal of clinical oncology, Vol.32(15_suppl), pp.e12002-e12002
05/20/2014
DOI: 10.1200/jco.2014.32.15_suppl.e12002

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Abstract

Background: In patients diagnosed with Breast Cancer (BC), adjuvant chemotherapy is an important treatment strategy toreduce risk of breast and systemic recurrence, as well as cancer death. The combination of Docetaxel and Cyclophosphamide (TC) is a well-recognized effective regimen. Nonetheless, a considerable high rate of febrile neutropenia (FN) may be associated with this regimen. We sought to investigate hematologic toxicity associated with adjuvant TC in a non-selected cohort of BC patients. Methods: We reviewed the electronic medical records of patients who presented to the Oncology Center from Hospital Sirio-Libanes (HSL) and Instituto do Cancer do Estado de Sao Paulo (ICESP) after definitive breast surgery to initiate adjuvant chemotherapy with TC. Results: 95 patients with early BC were included in our analysis. Median age was 55.5 years. All patients had a good performance status (Ecog 0 or 1) and the great majority of them had no comorbidities. Four chemotherapy cycles were given for most patients (80%). Data on G-CSF administration was available in 85 patients from our cohort. G-CSF was used as primary prophylaxis in 31 patients and in 13 patients as secondary prophylaxis, following a prior diagnosis of febrile neutropenia. Overall, fifteen women (15.8%) had a documented FN episode. Among women who received G-CSF as primary prophylaxis, the rate of FN was 6.45% (2 patients). In contrast, among patients who did not receive primary prophylaxis with G-CSF, the FN rate was considerably higher, namely 24.07% (13 patients). Patients who received primary prophylaxis with G-CSF had a statistically significant lower risk of experiencing a FN episode (p 0.049). Conclusions: Febrile Neutropenia rate in this group of non-selected BC patients was higher than previous reported on randomized controlled trials that evaluated adjuvant TC regimen in the same dosing and schedule as used in our cohort. Primary prophylaxis with G-CSF was associated with a statistically significant lower risk of FN and should be used in the management of patients who receive this chemotherapy combination.

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