title: Early-onset neutropenia during perioperative chemotherapy is predictive of increased survival in patients with completely resected non-small cell lung cancer: a retrospective analysis.
abstract: BACKGROUND
  Chemotherapy-induced neutropenia (CIN) has been found to be predictive of better therapeutic outcomes in studies of patients with various tumors. This study investigated whether CIN occurring during perioperative chemotherapy cycles 1 or 2 is a prognostic indicator in patients with completely resected non-small cell lung cancer (NSCLC).
  
  
  METHODS
  The records of patients with completely resected NSCLC receiving at least two cycles of perioperative platinum-based doublet chemotherapy were reviewed retrospectively. Early-onset CIN was defined as a neutrophil count <2.0 × 10(9)/l during chemotherapy cycles 1 or 2. Subjects were stratified into two groups: presence or absence of early-onset CIN.
  
  
  RESULTS
  A total of 93 patients were included in this analysis. Early-onset CIN developed in 54.8% (51/93) cases. The median overall survival (OS) of patients developing early-onset CIN was significantly longer than the survival of patients without early-onset CIN (92.4 vs. 35.8 months, p=0.022), and the median disease-free survival (DFS) of patients with early-onset CIN was also longer, although the difference was not significant (48.3 vs. 18.6 months, p=0.138). Multivariate analysis demonstrated that early-onset CIN was an independent prognostic indicator for OS [hazard ratio (HR) for death=0.422, 95% confidence interval (CI)=0.201-0.884; p=0.022] and DFS (HR for recurrence=0.482, 95% CI=0.247-0.943; p=0.033).
  
  
  CONCLUSIONS
  Early-onset CIN during perioperative chemotherapy is predictive of better OS and DFS in patients with completely resected NSCLC.
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University, Anyang, Gyeonggi, Korea.
authors.forename: Chang Youl
authors.initials: CY
authors.lastname: Lee
authors.forename: So Young
authors.initials: SY
authors.lastname: Park
authors.forename: Tae Rim
authors.initials: TR
authors.lastname: Shin
authors.forename: Yong-Bum
authors.initials: YB
authors.lastname: Park
authors.forename: Cheol-Hong
authors.initials: CH
authors.lastname: Kim
authors.forename: Seung Hun
authors.initials: SH
authors.lastname: Jang
authors.forename: Jae-Woong
authors.initials: JW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009503:Neutropenia / Q000139:chemically induced*; D019990:Perioperative Care; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin
keywords: Non-small cell lung cancer; chemotherapy-induced neutropenia; early-onset; prognosis; surgery