Change in Body Weight and Serum Albumin Levels in Febrile Neutropenic Lung Cancer Patients

Abstract

Although advances have been made in the treatment and prevention of febrile neutropenia (FN) in cancer patients treated with chemotherapy, it is still a complication that requires clinical attention. Impaired nutritional status in patients who develop FN can affect the continuation of cancer treatment, but it has not been investigated. We conducted a retrospective longitudinal study in order to clarify (1) if body weight and serum albumin levels change in lung cancer patients who do and do not develop FN, and (2) if these indicators are more likely to worsen in patients with FN than in patients without FN. Patients undergoing cytotoxic chemotherapy between January 2011 and June 2020 were consecutively included in the study. Changes in body weight and serum albumin levels were investigated in a case–control study of patients with FN, and control patients without FN who were matched by age, gender, histopathology, and stage of lung cancer, at a ratio of 1:2. During the study period, 226 patients received cytotoxic chemotherapy. Among those, 33 (14.6%) patients developed FN during the first course of cytotoxic chemotherapy. We found a more pronounced decrease in both body weight and serum albumin level at four weeks after the initiation of chemotherapy in FN patients. In order to safely administer effective chemotherapy, medical staff need to pay close attention to the nutritional status of patients receiving chemotherapy.

Treatment-Interval Changes in Serum Levels of Albumin and Histidine Correlated with Treatment Interruption in Patients with Locally Advanced Head and Neck Squamous Cell Carcinoma Completing Chemoradiotherapy under Recommended Calorie and Protein Provision

“…Our results for LAHNSCC were partially consistent with those of previous reports on other malignancies [139][140][141][142][143]. Patients with esophageal cancer receiving CCRT who exhibited increased albumin levels during the treatment course had better survival outcomes [139,143].…”

“…Patients with esophageal cancer receiving CCRT who exhibited increased albumin levels during the treatment course had better survival outcomes [139,143]. Kayauchi et al analyzed 226 patients with lung cancer undergoing cytotoxic chemotherapy, and reported that patients with decreased albumin levels during treatment significantly suffered from febrile neutropenia toxicity [141]. The histidine degradation pathway is essential for determining the chemosensitivity of tumor cells to methotrexate; thus, the addition of histidine to methotrexate significantly reduces tumor growth in animal models [140].…”

Management of Febrile Neutropenia in Lung Cancer

“…The incidence of FN may decrease due to the therapeutic impact of G-CSF therapy. 12 The retrospective study revealed an incidence of 58.3% for neutropenia and 8.3% for FN in advanced NSCLC patients undergoing platinum-based chemotherapy doublets. 13 Fujiwara et al research showed the incidence of FN was 20% in lung cancer patients in Japan who had never received chemotherapy while receiving etoposide and platinum in combination.…”