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P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
P1.01-045 - Drug Fever After Cancer Chemotherapy Is Most Commonly Observed on Post-Treatment Days 3-4 (ID 466)
09:30 - 17:00 | Author(s): K. Nakatomi
Fever during cancer chemotherapy is require attention using antibiotics to prevention severe infection. On the other hand, it should be avoid using antibiotics to non-infectious fever such as drug and tumor fever with the object of development of resistant bacteria, exacerbation of drug fever, and medical economics.
Retrospectively, 1,016 consecutive cycles of cancer chemotherapy were analyzed. Fever was defined as a temperature of ≥37.5°C. Age, sex, tumor histology, the treatment regimen, the timing of fever onset, the number of days for which the fever persisted, the cause of the fever, and the presence or absence of radiotherapy were examined.
Seventy-four percent of the patients (748 of 1016) were males, the patients’ median age was 68 years (range: from 29 to 88 years), and lung cancer was the most common disease (93%). Fevers occurred in 36% of cycles (367 of 1016) including 37% of those involving males and 32% of those involving females. There was no difference in the frequency of fever among the sexes (p=0.146). The incidence of fever according to age were 33% (≤60), 41% (61-65), 36% (66-70), 33% (71-75), 41% (76-80), and 33% (≥81); it did not differ significantly with age (p=0.424). In incidence of fever according to the drugs administered, gemcitabine was the drug that was most frequently associated with fever (41%; 43/106), followed by irinotecan (40%; 108/272), amrubicin (39%; 29/75), and docetaxel (36%; 47/131). Post-treatment days 4 (8.3%), 3 (6.8%), and 12 (6.7%) were the days on which fever was most common. The distribution of fever exhibited a bimodal distribution; i.e., whilst it peaked on post-treatment days 3 and 4; otherwise, it generally gradually increased until day 12 and then gradually decreased. The peak on post-treatment days 3-4 was considered to be due to adverse drug reactions, and the latter peak was considered to represent neutropenic or infection-based fevers. Fevers occurred on post-treatment days 3-4 in 11% of all cycles (113 of 1016) including 11% (84 of 748) of the cycles involving males and 11% (29 of 268) of those involving females. The incidence of fever on post-treatment days 3-4 according to age were 12% (≤60), 13% (61-65), 10% (66-70), 8% (71-75), 13% (76-80), and 10% (≥81); however, this parameter did not differ significantly with age (p=0.427). The incidence of fever on post-treatment days 3-4, gemcitabine was the drug that was most commonly associated with fever (20%), followed by docetaxel (18%), nedaplatin (12%), and carboplatin (11%). The patients’ fevers were caused by infections (47%), adverse drug reactions (24%), unknown causes (19%), and tumors (7%). The causative infections included febrile neutropenia (50%), pneumonia (18%), unidentified infections (9%), and colitis (7%). The incidence of fever was significantly higher among the patients treated with radiotherapy than among those that did not receive radiotherapy (46% vs. 34%, p=0.001).
The febrile episodes that occurred on post-treatment days 3-4 were considered to represent adverse drug reactions after cancer chemotherapy. Physicians should be aware of this feature of chemotherapy-associated fever and avoid unnecessary examination and treatments including prescribing antibiotics.
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