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Japanese Journal of Clinical Oncology 21:353-359 (1991)
© 1991 Foundation for Promotion of Cancer Research

research-article

The Frequency and Management of Infectious Episodes and Sepsis in Small Cell Lung Cancer Patients Receiving Intensive Chemotherapy with Granulocytecolony Stimulating Factor

Fumihiro Oshita1, Tomohide Tamura1, Hiroaki Okamoto1, Toshimichi Miya1, Akira Kojima1, Yuichiro Ohe1, Yasutsuna Sasaki1, Kenji Eguchi1, Tetsu Shinkai1 and Nagahiro Saijo2,*

1Department of Internal Medicine, National Cancer Center Hospital 1-1, Tsukiji 5-chome, Chuo-ku, Tokyo 104
2Pharmacology Division, National Cancer Center Research Institute 1-1, Tsukiji 5-chome, Chuo-ku, Tokyo 104

*For reprints and all correspondence

Received December 17, 1991; accepted May 11, 1991

The relation between degree of myelosuppression and episodes of infection was analyzed in 36 patients (92 treatment courses) with small cell lung cancer (SCLC) treated with intensive chemotherapy. The two regimens used were cisplatin (CDDP)+adriamycin (ADR)+cyclophosphamide (CPA)+etoposide (VP-16)+granulocyte-colony stimulating factor (G-CSF) and CDDP+ teniposide (VM-26)+G-CSF, and they induced grade 3 or 4 leukopenia in 88% of treatment courses and febrile episodes in 60%. In the febrile courses, the mean nadirs of leukocyte and neutrophils (820±581/mm3, 101±267/mm3) were significantly longer (P<0.01) and the mean durations of grade 3 and 4 leukopenia and neutropenia significantly longer (P< 0.001) than those of the non-febrile courses. It was noted, however, that febrile episodes appeared frequently in courses having the nadir of leukocytes below 1,000/mm3 (80%) or the nadir of neutrophils below 100/mm3 (74%). The administration of antibiotics was required for about 7 days to patients with febrile episodes. Sepsis was experienced in five courses, in which the neutrophils were all zero. All the patients, however, could be managed by an administration of antibiotics immediately after a febrile episode appeared, without delaying the subsequent chemotherapy except for one patient, who had had a performance status (PS) of 3 prior to chemotherapy.

Key Words: Small cell lung cancer • Intensive chemotherapy with G-CSF • Myelosuppression • Infection • Sepsis


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