Can MASCC and CISNE scores predict delays of lung cancer chemotherapy after febrile neutropenia?. Issue 24 (4th November 2022)

• Record Type: Journal Article
• Authors: Ono, Yoshitaka; Hayama, Naoki; Hattori, Shigeaki; Ito, Yoko; Oguma, Tsuyoshi; Sakamaki, Fumio; Asano, Koichiro
• Is Part Of: Thoracic cancer. Volume 13:Issue 24(2022)
• Page Start: 3504
• Page End: 3509
• Publication Date: 2022-11-04
• Subjects: chemotherapy -- complication -- febrile neutropenia -- prediction -- prognosis; Chest -- Cancer -- Periodicals; Chest -- Cancer -- Treatment -- Periodicals; Chest -- Surgery -- Periodicals; 616.99494005
• DOI: 10.1111/1759-7714.14720
• Languages: English
• ISSNs: 1759-7706

Abstract

Abstract: Background: Febrile neutropenia (FN) during cancer chemotherapy can lead to morbidity and mortality. The Multinational Association of Supportive Care in Cancer (MASCC) and clinical index of stable febrile neutropenia (CISNE) scores have been widely used to predict the risk of severe medical complications in patients with FN; however, there are few tools for predicting chemotherapy delays or discontinuation after FN. Methods: Patients admitted to two university hospitals between 2014 and 2018 with a FN diagnosis during the first cycle of chemotherapy for lung cancer were reviewed retrospectively. Results: Among 539 patients who received 813 courses of chemotherapy for lung cancer, 49 (9%) developed FN during the first treatment cycle. Although all the patients recovered from their primary infection, 19 patients (38.8%) developed serious medical complications, 11 (22.4%) were unable to resume chemotherapy and one (2.0%) declined to resume chemotherapy, and nine (18.4%) died within 90 days. Patients who failed to resume chemotherapy had a lower MASCC score (median 8.5 vs. 17, p < 0.01) and a higher CISNE score (median 3 vs. 1, p < 0.01) at the onset of FN. The specificity to predict the patient who failed to resume chemotherapy was 90% or more with MASCC score ≤9 or CISNE score ≥3, with the sensitivity of 61%. MASCC score ≤ 16 can also be a sensitive indicator with the sensitivity and specificity of 89 and 52%, respectively. Conclusion: The MASCC and CISNE scores are useful in identifying lung cancer patients who are unable to resume chemotherapy as scheduled after the onset of FN. Abstract : Forty‐nine patients developed febrile neutropenia (FN) during 813 courses of lung cancer chemotherapy; 12 patients were unable or declined to resume chemotherapy even after recovery of infection and nine of them died within 90 days. The MASCC and CISNE scores, widely used to predict the risk of severe medical complications during FN, were also useful to identify lung cancer patients who are unable to resume chemotherapy as scheduled and exhibit poor prognosis after the onset of FN.