Rutgers, K. (Kirsten) (2014) Primaire profylaxe tegen febriele neutropenie bij één cyclus binnen het FEC-D chemotherapieschema voor mammacarcinoom. thesis, Medicine.
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Abstract
Chemotherapy that combines anthracyclines with taxanes, such as FEC-D (three times 5- fluorouracil-epirubicine-cyclofosfamide followed by three times docetaxel) improves survival in women with breast cancer. Since this therapy is myelosuppressive, febrile neutropenia is a possible side effect. The incidence of febrile neutropenia during FEC-D chemotherapy is markedly higher in retrospective research than in the randomized clinical trial FEC-D was first investigated in. Especially patients undergoing the fourth cycle of chemotherapy, which is the first consisting of docetaxel, are prone to develop febrile neutropenia. Granulocytecolony stimulating factors (G-CSF), when administered during every cycle of chemotherapy, can reduce the incidence of febrile neutropenia. Since febrile neutropenia is primarily a problem in the first docetaxel cycle, administering G-CSF only in this cycle might reduce the overall incidence of febrile neutropenia. To examine this hypothesis a retrospective cohort study was performed, comparing a group of patients receiving G-CSF in the fourth cycle with a group not receiving any G-CSF. The incidence of febrile neutropenia decreased markedly in the fourth cycle, but was not significantly changed overall. During the docetaxel treatment, 22.2% of the patients developed febrile neutropenia, which is comparable to other retrospective studies. Besides this, 20.7% of patients did not complete the FEC-D therapy, due to toxicity. It should be considered whether this toxicity is acceptable. Because the overall incidence of febrile neutropenia exceeds the 20%, it should also be considered whether patients should receive G-CSF with every cycle. More research is needed to identify patients at high risk for febrile neutropenia, so G-CSF can be used more effectively.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Honkoop, Dr. A.H. and Afdeling Interne Geneeskunde and Isala, Zwolle |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:56 |
| Last Modified: | 25 Jun 2020 10:56 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1667 |
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