title: Factors predicting severe infections during chemotherapy in head and neck cancer patients.
abstract: CONCLUSIONS
  The head and neck cancer patients with more co-morbidities and those dependent on tube feeding are at a high risk of severe infections during chemotherapy. Therefore, prophylaxis with colony-stimulating factors and/or antibiotics should be considered for those patients.
  
  
  OBJECTIVE
  To investigate the risk factors for severe infection during chemotherapy in head and neck cancer patients.
  
  
  METHODS
  A retrospective study was conducted of 129 patients with head and neck cancer who received taxane-based and platinum-based chemotherapy between 2008-2013. Logistic regression models were used to evaluate risk factors.
  
  
  RESULTS
  Febrile neutropenia occurred in 50 patients out of the 129 (39%), severe infections occurred in 24 patients (19%), and bacteremia in two patients (2%). In univariate analysis, low serum albumin levels and tube feeding were significantly associated with severe infections (p = 0.015 and < 0.001, respectively). In multivariate analysis, the odds ratios for a higher modified Charlson co-morbidity index and tube feeding were 2.80 and 9.74, respectively. These two were independent predictive factors for severe infections (p = 0.020 and 0.001, respectively).
authors.affiliation: Department of Otorhinolaryngology, Toyonaka Municipal Hospital , Toyonaka , Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sasaki
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Takenaka
authors.forename: Tarou
authors.initials: T
authors.lastname: Hayashi
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Hironori
authors.initials: H
authors.lastname: Cho
authors.forename: Takahito
authors.initials: T
authors.lastname: Fukusumi
authors.forename: Norihiko
authors.initials: N
authors.lastname: Takemoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hanamoto
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Yasui
authors.forename: Susumu
authors.initials: S
authors.lastname: Nakahara
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Mitani
authors.forename: Hidenori
authors.initials: H
authors.lastname: Inohara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: Chemotherapy; co-morbidity; febrile neutropenia; sepsis; septic shock; severe sepsis; tube feeding