title: Attitudes of physicians toward assessing risk and using granulocyte colony-stimulating factor as primary prophylaxis in patients receiving chemotherapy associated with an intermediate risk of febrile neutropenia.
abstract: Febrile neutropenia (FN) is a potentially fatal complication of chemotherapy. This prospective, observational study describes physicians' approaches toward assessing FN risk in patients receiving chemotherapy regimens with an intermediate (10-20 %) FN risk. In the baseline investigator assessment, physicians selected factors considered important when assessing overall FN risk and deciding on granulocyte colony-stimulating factor (G-CSF) primary prophylaxis (PP). Physicians then completed patient assessments using the same lists of factors. The final FN risk scores and whether G-CSF PP was planned were reported. The final analysis included 165 physicians and 944 patients. The most frequently considered factor in both assessments was chemotherapy agents in the backbone (88 % of investigator and 93 % of patient assessments). History of FN (83 %), baseline laboratory values (76 %) and age (73 %) were commonly selected at baseline, whereas tumor type (72 %), guidelines (62 %) and tumor stage (43 %) were selected most during patient assessments. Median investigator-reported FN risk threshold for G-CSF PP was 20 % (range 10-85 %). G-CSF PP was planned in 82 % of patients with an FN risk at or above this threshold; therefore, almost one-fifth of qualifying patients would not receive G-CSF PP. Physicians generally follow guidelines, but also consider individual patient characteristics when assessing FN risk and deciding on G-CSF PP. A standardized FN risk assessment may optimize the use of G-CSF PP, which may minimize the incidence of FN in patients undergoing chemotherapy with an intermediate FN risk. ClinicalTrials.gov Identifier: NCT01813721.
authors: Department of Medical Oncology, Hospices Civils de Lyon Cancer Institute, Lyon University, Lyon, France, gilles.freyer@univ-lyon1.fr.
authors: Gilles
authors: G
authors: Freyer
authors: Ewa
authors: E
authors: Kalinka-Warzocha
authors: Konstantinos
authors: K
authors: Syrigos
authors: Mihai
authors: M
authors: Marinca
authors: Giuseppe
authors: G
authors: Tonini
authors: Say Liang
authors: SL
authors: Ng
authors: Zee Wan
authors: ZW
authors: Wong
authors: Antonio
authors: A
authors: Salar
authors: Guenther
authors: G
authors: Steger
authors: Mahmoud
authors: M
authors: Abdelsalam
authors: Lucy
authors: L
authors: DeCosta
authors: Zsolt
authors: Z
authors: Szabo
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D001291:Attitude of Health Personnel; D064147:Febrile Neutropenia / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D010820:Physicians; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents; D016179:Granulocyte Colony-Stimulating Factor