THE EFFECT OF NEUTROPENIA ON THE RESULTS OF TREATMENT OF PATIENTS WITH BREAST CANCER

Prokhach A. V., Bondarenko I. N., Zavizion V. F.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

In recent years, interest in studying the effect of neutropenia on survival rates of patients with solid tumors during chemotherapy has been increasing. Some publications demonstrate the positive effects of neutropenia associated with the administration of cytostatics, on the results of treatment. Other studies claim that there is no such effect, or negative effects. Thus, the question of the relationship between the presence of neutropenia, its degree of severity and the response of the tumor to treatment remains open. The goal was to study the effect of neutropenia on the effectiveness of systemic treatment of breast cancer patients and to evaluate the rates of overall and non-recurrent survival of patients, depending on the presence of neutropenia during the therapy. The study involved 110 patients with a morphologically verified diagnosis of breast cancer. All patients received chemotherapy for breast cancer according to taxan + anthracycline scheme once every 3 weeks intravenously. The patients developed the expected complications of systemic treatment. We used clinical, laboratory methods of investigation. It was found that neutropenia on the first course of chemotherapy was registered in 78,2% of patients, including neutropenia 1-2 st. – 27,3%, 3-4 st. – in 50,9% of patients. Since the 3rd course of chemotherapy, the number of registered neutropenia, primarily 3-4 st., has decreased. It was established that the results of systemic therapy are influenced by the parameters of leukocytes and neutrophils, as one of their fractions. The absence of neutropenia in the treatment process leads to a worse response of the tumor to therapy on CT results after 3 and 6 courses of therapy. At the same time, the normalization of the neutrophil count on the day of conducting the course of chemotherapy, as a factor allowing the introduction of drugs, is a marker for better prognosis. In assessing the overall survival rates of patients since the start of treatment according to the chosen pattern after 6 courses of therapy, it was determined that in women with neutropenia in the process of treatment, the median survival was 1.61 times higher than in patients without hematologic toxicity. After conducting 6 courses of polychemotherapy in patients with a slight degree of neutropenia, the median of overall survival was 41.35 months, and non-recurrent survival rate was 15.92 months. In women who had a severe neutropenia of 3-4 degrees of median total survival in the process of chemotherapy was 18.15 months and nonrecurrent survival rate of 9.82 months. Thus, in the presence of light-weight neutropenia, the overall survival rate is 2.28 times greater than that in patients with a more pronounced decrease in granulocyte parameters. Similarly, the rate of non-recurrent survival in patients with neutropenia 1-2 degrees is 1.62 times higher than in patients with grade 3-4 neutropenia.

neutropenia, breast cancer, chemotherapy

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«Bulletin of problems biology and medicine» Issue 4 Part 3 (141), 2017 year, 209-212 pages, index UDK 616-006.66; 616-035.1; 616-08-06

10.29254/2077–4214–2017–4–3–141–209-212