Chemotherapy-induced neutropenia with FOLFOX in the adjuvant treatment of colorectal cancer.
Notice bibliographique
Résumé
38 Background: Patients undergoing adjuvant treatment with FOLFOX for colorectal cancer (CRC) are at risk of developing chemotherapy-induced neutropenia (CIN). We assessed the risk of CIN and the use of granulocyte colony stimulating factor (GCSF). Methods: We performed a retrospective chart review of patients with CRC treated with FOLFOX at our institution from 2013 - 2015. Demographic and treatment data were collected. CIN was defined as ANC <1.5, and all episodes of neutropenia were assumed to be the result of chemotherapy. Results: A total of 302 patients were included (baseline demographics in Table). In the overall cohort, 174 (58%) of patients had at least 1 episode of CIN. The risk CIN was 47% in stage II, 60% in low risk stage III (T1-3 and N1), and 58% in high risk stage III (T4 or N2). Among patients with at least 1 episode of CIN, the 1st CIN event occurred during the 1st 3 months of treatment in 76%, and the median cycle of 1st occurrence was 4 (95% CI 4-5), which did not differ by stage. Among patients who had at least 1 episode of CIN, 112 (64%) had a 2nd episode at a median cycle of 9 (95% CI 8-10). Among patients with at least 1 episode of CIN, 79 (45%) received subsequent GCSF, initiated 1 cycle after the 1st CIN event 37% of the time. Among patients with at least 2 episodes of CIN (n=112), 58 (52%) received GCSF after the 1st or 2nd event. Of these, 40 patients (69%) started GCSF newly after the 2nd CIN event. Among patients starting GCSF after the 2nd CIN event, 47% initiated GCSF 1 cycle later. The median cycle at which the relative dose intensity of FOLFOX decreased to <85% was cycle 6 (95% CI 5-8) in those with no CIN events, cycle 3 (95% CI 2-4) in those with at least 1 CIN event treated with GCSF, and cycle 5 (95% CI 4-6) in those with at least 1 CIN event treated without GCSF. Conclusions: CIN is a frequent occurrence during the adjuvant treatment of CRC with FOLFOX and most often occurs in the first 3 months of treatment. While oncologists may treat some patients with 3 months of FOLFOX rather than 6, physicians must be aware of CIN regardless of the planned duration of treatment. Early initiation of GCSF may be a consideration. [Table: see text]
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».