title: Score of liver ultrasonography predicts treatment-related severe neutropenia and neutropenic fever in induction chemotherapy with docetaxel for locally advanced head and neck cancer patients with normal serum transamines.
abstract: Induction chemotherapy with docetaxel improved outcome in advanced head and neck squamous cell carcinoma (HNSCC) patients, but docetaxel was not recommended in liver dysfunction patients for treatment toxicities. Severe neutropenic events (SNE) including severe neutropenia (SN) and febrile neutropenia (FN) still developed in these patients with normal serum transaminases. Ultrasonography (US) fibrotic score represented degree of hepatic parenchymal damage and showed good correlation to fibrotic changes histologically. This study aims to evaluate the association of US fibrotic score with docetaxel treatment-related SNE in advanced HNSCC patients with normal serum transaminases. Between 1 January 2011 and 31 December 2013, a total of 47 advanced HNSCC patients treated with induction docetaxel were enrolled. The clinical features were collected to assess predictive factors for SNE. The patients were divided into two groups by the US fibrotic score with a cutoff value of 7. The Mann-Whitney U test and logistic regression method were used for the risk factor analysis. The background, treatment, and response were similar in both groups except for lower lymphocyte and platelet count in patients with higher US score. Twenty-seven patients (51 %) developed grade 3/4 neutropenia, and more SNE developed in patients with US score ≧7. In multivariate analysis, only US score ≥7 was independent predictive factor for developing SN (hazard ratio 7.71, p = 0.043) and FN (hazard ratio 20.95, p = 0.008). US score ≥7 is an independent risk factor for SNE in advanced HNSCC patients treated with induction docetaxel. US score could be used for risk prediction of docetaxel-related SNE.
authors.affiliation: Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Ting-Yao
authors.initials: TY
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Chen
authors.affiliation: Biostatistics Unit, Clinical Trial Centre and Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Lan-Yan
authors.initials: LY
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Department of Hematology and Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan.
authors.forename: Wen-Chi
authors.initials: WC
authors.lastname: Chou
authors.affiliation: Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Yi-Yang
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Chen
authors.affiliation: Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Kuan-Der
authors.initials: KD
authors.lastname: Lee
authors.affiliation: Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan. q12014@adm.cgmh.org.tw.|, No.6, W. Sec., Chia-Pu Rd., Puzi City, Chiayi County 613, Taiwan. q12014@adm.cgmh.org.tw.
authors.forename: Chang-Hsien
authors.initials: CH
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D000077143:Docetaxel; D005260:Female; D005334:Fever / Q000209:etiology*; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D060828:Induction Chemotherapy / Q000009:adverse effects*; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology*; D012307:Risk Factors; D043823:Taxoids / Q000009:adverse effects*; D014463:Ultrasonography / Q000379:methods*
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel
keywords: Docetaxel; Neutropenia; Risk factors; Ultrasonography