肺癌患者发热性中性粒细胞减少症的处理

H. Haryati, Nida Amalia
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引用次数: 0

摘要

发热性中性粒细胞减少症(FN)的定义是:在接受癌症全身化疗的个体中,口腔温度>38.3°C或2小时内连续两次>38°C,并伴有绝对中性粒细胞计数(ANC) 500/L或预测降至500/L以下。FN是一种可以影响癌症患者预后的肿瘤紧急情况,因为它可以增加发病率、延迟治疗、降低生存率和增加费用。肺癌患者FN的发生率为3.7-28%。FN发作相关的死亡率为15%。FN危险因素包括化疗方案、年龄、合并症、黏膜炎、运动状态和FN病史。经过验证的预测工具,如多国癌症支持治疗协会(MASCC)或稳定发热性中性粒细胞减少临床指数(CISNE)评分,可以帮助评估FN的风险并确定是否进行了晚期治疗。FN的有效治疗需要尽早调查诊断并确认潜在的感染源。预防性粒细胞集落刺激因子(G-CSF)和抗微生物药物成功地降低了FN引起的死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
MANAGEMENT OF FEBRILE NEUTROPENIA IN LUNG CANCER
Febrile neutropenia (FN) is defined as an oral temperature of >38.3° C or two consecutive measures > 38° C within 2 hours accompanied by an absolute neutrophil count (ANC) of 500/L or a predicted decrease below 500/L in individuals undergoing systemic chemotherapy for cancer. FN is one of the oncological emergencies that can influence cancer patients' outcomes since it can increase morbidity, treatment delays, decreased survival, and expanded costs. The incidence of FN is 3.7-28% in lung cancer patients. Mortality associated with FN episodes is 15%. FN risk factors include chemotherapy regimen, age, comorbidities, mucositis, performance status, and previous FN history. Validated predicted instruments such as The Multinational Association for Supportive Care in Cancer (MASCC) or The Clinical Index of Stable Febrile Neutropenia (CISNE) score could assist in risk assessment of FN and determine advanced management. Effective therapy of FN requires investigation of diagnosis as soon as possible and acknowledging the potential source of infection. The prophylactic granulocyte colony-stimulating factors (G-CSF) and anti-microbials successfully reduced mortality due to FN.
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