title: Granulocyte-colony-stimulating factor in elderly patients receiving chemotherapy for breast and gynaecological cancers: results of a French survey.
abstract: BACKGROUND
  Age is a risk factor for chemo-induced febrile neutropenia (FN). According to ASCO guidelines, granulocyte colony-stimulating factor (G-CSF) use should be considered for regimens leading to a 10- to 20-percent risk of FN.
  
  
  METHODS
  A survey was undertaken describing the prescription of G-CSF in routine practices by 101 French physicians for 791 patients ≥70 years, having breast or gynaecological cancers, and receiving chemotherapy.
  
  
  RESULTS
  G-CSF was prescribed in 51% of the cases. A primary prophylaxis was prescribed in 90%, 59% and 36% of patients receiving regimens presenting a FN-risk of ≥20%, 10-20% and <10%, respectively. Covariates associated with the use of G-CSF were adjuvant chemotherapy, 3- or 4-weekly regimens, and geriatric assessment. Validated risk factors of FN were rarely considered.
  
  
  CONCLUSIONS
  The prescription of G-CSF was multi-factorial. The estimation of FN risk was mainly based on physician's experience, explaining differences between guidelines and routine practice.
authors.affiliation: Department of Geriatrics, Centre Hospitalier Lyon Sud, Pierre-Bénite, France claire.falandry@chu-lyon.fr.
authors.forename: Claire
authors.initials: C
authors.lastname: Falandry
authors.affiliation: Department of Medical Oncology, Centre Alexis Vautrin, Vandoeuvre-les-Nancy, France.
authors.forename: Ivan
authors.initials: I
authors.lastname: Krakowski
authors.affiliation: Department of Medical Oncology, Centre Jean Godinot, Reims, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Curé
authors.affiliation: Department of Medical Oncology, Centre Hospitalier Général, Senlis, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Carola
authors.affiliation: Department of Medical Oncology, Institut Bergonié, Bordeaux, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Soubeyran
authors.affiliation: Department of Geriatrics, Hôpital Cimiez, Nice, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Guérin
authors.affiliation: Department of Medical Oncology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Freyer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005602:France / Q000453:epidemiology; D005833:Genital Neoplasms, Female / Q000150:complications* / Q000188:drug therapy; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control*; D010820:Physicians; D011292:Premedication
chemical_list: D016179:Granulocyte Colony-Stimulating Factor
keywords: Breast cancer; chemotherapy; elderly patients; granulocyte-colony stimulating factor; guidelines; gynaecological cancers