BACKGROUND:
Breast cancer clinical trials prove better outcomes for anthracycline-taxane
regimes albeit of a higher hematologic toxicity. Original trials may
under-estimate febrile neutropenia (FN) event rates.
OBJECTIVE:
To describe the occurrence of FN events related to FEC-D for breast cancer
treatment in the real-life setting.
METHODS:
Retrospective analysis of 189 patients with non-metastatic breast cancer
consecutively treated with FEC-D (3 cycles of 5-FU, Epirubicin and
Cyclophosphamide followed by 3 cycles of Docetaxel) at our Center during 33
months. FN and related dose delay and reduction, regimen change, G-CSF
prophylaxis and hospitalization were analyzed.
RESULTS:
Fifty-one patients (27%) developed at least one episode of FN during
FEC-D, 21% during Docetaxel cycles. There were 61 (5.6%) FN episodes
in 1100 cycles of FEC-D administered, 77% occurred during Docetaxel
cycles (46% on the first D cycle). G-CSF was used in 5.8% of cycles.
Hospital admission needed in 54.1% of FN events, 16.4% prompted dose
reduction and 23% next cycle delay. There were no FN related deaths.
CONCLUSIONS:
G-CSF prophylaxis is recommended for chemotherapy regimens associated with a
FN rate higher than 20%. Based on our FN rates, we now recommend primary
G-CSF prophylaxis during the administration of cycles 4 to 6 in FEC-D.
