Incidence of febrile neutropenia in patients with early-stage breast cancer receiving adjuvant FEC-D treatment.

Abstract

e11520 Background: Adjuvant chemotherapy is associated with serious toxicities such as febrile neutropenia (FN). FEC-D is currently the most common taxane-containing regimen used for early stage breast cancer (ESBC). In clinical practice, clinicians have noted a much higher rate of FN. The aim of the present study was to examine the incidence of FN in women receiving FEC-D for the treatment of ESBC. Secondary aims included reporting hospital admission and length of stay of patients with FN and the potential benefit of using granulocyte colony-stimulating factors (G-CSF) as primary prophylaxis with FEC-D. Methods: Retrospective chart reviews was conducted on all women with breast cancer referred to The Moncton Hospital, Canada between January 2005 and December 2009. The collected data was subsequently entered manually into Microsoft Access, which is used to build the Moncton Hospital Breast Cancer database. The data collected included: patient demographics, staging, hormone receptor status, number of patients treated with FEC-D, FN rate, admission to hospital, length of hospitalization and use of G-CSF. Results: A total of 127 patients were treated with FEC-D. Of these, 41 experienced FN, giving a total incidence of 32%. All of these patients required hospitalization with an average length of stay of 5.78 days. There was no toxic death. Patients who received primary prophylaxis had a lower incidence of FN (10%; 2/21) compared to those who did not receive primary prophylaxis (37%; 39/106). Further analysis of our data revealed that 44% of FN occurred during the FEC treatment while the remaining 56% occurred during the Docetaxel treatment. Conclusions: The incidence of FN in this retrospective analysis of ESBC patients receiving adjuvant FEC-D treatment without primary prophylaxis demonstrates a much higher rate(37%) than the rate initially reported in the PACS-01 study (11.4%). Our observations are consistent with those of other studies which also report high incidences of FN (24% and 29.4%). Patients who received primary prophylaxis in the present study had a lower incidence of FN (10%). Consistent with ASCO guidelines, prophylactic G-CSF should be considered for ESBC patients receiving an adjuvant FEC-D regimen.