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Score of liver ultrasonography predicts treatment-related severe neutropenia and neutropenic fever in induction chemotherapy with docetaxel for locally advanced head and neck cancer patients with normal serum transamines

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Abstract

Induction chemotherapy with docetaxel improved outcome in advanced head and neck squamous cell carcinoma (HNSCC) patients, but docetaxel was not recommended in liver dysfunction patients for treatment toxicities. Severe neutropenic events (SNE) including severe neutropenia (SN) and febrile neutropenia (FN) still developed in these patients with normal serum transaminases. Ultrasonography (US) fibrotic score represented degree of hepatic parenchymal damage and showed good correlation to fibrotic changes histologically. This study aims to evaluate the association of US fibrotic score with docetaxel treatment-related SNE in advanced HNSCC patients with normal serum transaminases. Between 1 January 2011 and 31 December 2013, a total of 47 advanced HNSCC patients treated with induction docetaxel were enrolled. The clinical features were collected to assess predictive factors for SNE. The patients were divided into two groups by the US fibrotic score with a cutoff value of 7. The Mann–Whitney U test and logistic regression method were used for the risk factor analysis. The background, treatment, and response were similar in both groups except for lower lymphocyte and platelet count in patients with higher US score. Twenty-seven patients (51 %) developed grade 3/4 neutropenia, and more SNE developed in patients with US score ≧7. In multivariate analysis, only US score ≥7 was independent predictive factor for developing SN (hazard ratio 7.71, p = 0.043) and FN (hazard ratio 20.95, p = 0.008). US score ≥7 is an independent risk factor for SNE in advanced HNSCC patients treated with induction docetaxel. US score could be used for risk prediction of docetaxel-related SNE.

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Acknowledgments

The authors thank the Office of Medical Records and the Office of Medical Information, Chang-Gung Memorial Hospital, for providing the data of the patients.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan

    Ting-Yao Wang, Yi-Yang Chen, Chih-Cheng Chen, Kuan-Der Lee & Chang-Hsien Lu

  2. Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Chiayi, Taiwan

    Wei-Ming Chen

  3. Biostatistics Unit, Clinical Trial Centre and Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Lan-Yan Yang

  4. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chiayi, Taiwan

    Chao-Yu Chen

  5. Department of Hematology and Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan

    Wen-Chi Chou

  6. No.6, W. Sec., Chia-Pu Rd., Puzi City, Chiayi County 613, Taiwan

    Chang-Hsien Lu

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  1. Ting-Yao Wang
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Correspondence to Chang-Hsien Lu.

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Wang, TY., Chen, WM., Yang, LY. et al. Score of liver ultrasonography predicts treatment-related severe neutropenia and neutropenic fever in induction chemotherapy with docetaxel for locally advanced head and neck cancer patients with normal serum transamines. Support Care Cancer 24, 4697–4703 (2016). https://doi.org/10.1007/s00520-016-3318-8

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