早期乳腺癌新辅助治疗导致发热性中性粒细胞减少症临床病理分析

A clinicopathological analysis of neoadjuvant therapy for early breast cancer complicated with febrile neutropenia

目的 研究早期乳腺癌新辅助治疗合并发热性中性粒细胞减少症(FN)的危险因素并探讨新辅助治疗近期疗效。方法 回顾性分析2018-01-01—2022-06-30北京大学第一医院乳腺疾病中心行新辅助治疗的乳腺癌病人的临床病理资料。结果 370例早期乳腺癌病人接受不同方案新辅助治疗,其中32例发生FN,占8.6%。FN发生与年龄、基础疾病以及蒽环联合紫杉类化疗方案具有相关性(P<0.05)。预防性应用长效或短效粒细胞刺激因子与FN发生率差异无统计学意义(P=0.791)。FN与病理完全缓解(pCR)无相关性(P=0.497)。结论 病人年龄>65岁,伴随基础疾病以及蒽环联合紫杉化疗方案是出现FN的主要危险因素。新辅助治疗期间预防性应用长效或短效粒细胞刺激因子的疗效相同,均可以降低FN发生率,且安全性好,不延迟手术时机。

Objective To study the risk factors of febrile neutropenia(FN)after neoadjuvant therapy for early breast cancer and explore the short-term efficacy of neoadjuvant therapy.Methods The clinical data of early breast cancer patients undergone neoadjuvant therapy in Breast Disease Center of the Peking University First Hospital from January 1st 2018 to June 30th,2022 were analyzed retrospectively.Results A total of 370 patients with early breast cancer underwent neoadjuvant therapy with different regiments,among which 32 cases developed FN,accounting for 8.6%.Clinicopathological analysis showed that FN was correlated with advanced age,the presence of background diseases,and the use of anthracene combined with taxanes(P<0.05).There was no significant difference in the proportion of FN after prophylactic use of long-acting or short-acting granulocytic stimulating factor(P=0.791).There was no correlation between FN and pCR(P=0.497).Conclusion In the case of prophylactic application of granulocytic stimulating factor,the incidence of FN in patients underwent neoadjuvant therapy was lower,the safety was better,and the operation time is not delayed.Patients who were elder than 65 years old,had background diseases and received the regimen with the combination of anthracene and taxanes were the main cause of FN.Prophylactic use of long-acting granulocytic stimulating factor did not reduce the incidence of FN compared with short-acting form.