Nobu Akiyama1, Takuho Okamura2, Minoru Yoshida3, Shun-Ichi Kimura4, Shingo Yano5, Isao Yoshida6, Hiroyuki Kusaba7, Kosuke Takahashi8, Hiroyuki Fujita9, Keitaro Fukushima10, Hiromichi Iwasaki11, Kazuo Tamura12, Toshiaki Saeki13, Yasushi Takamatsu14, Sadamoto Zenda15. 1. Department of Internal Medicine, School of Medicine, Teikyo University, Kaga 2-11-1, Itabashi ward, 173-8605, Tokyo, Japan. nobak39@yahoo.co.jp. 2. Department of Breast and Endocrine Surgery, School of Medicine, Tokai University, Isehara, Kanagawa, Japan. 3. Fourth Department of Internal Medicine, Teikyo University Hospital Mizonokuchi, Kawasaki, Kanagawa, Japan. 4. Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Saitama, Japan. 5. Division of Clinical Oncology and Hematology, The Jikei University School of Medicine, Minato, Tokyo, Japan. 6. Department of Hematologic Oncology, National Hospital Organization Shikoku Cancer Center, Matuyama, Ehime, Japan. 7. Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan. 8. Department of Respiratory Medicine, Anjo Kosei Hospital, Anjo, Aichi, Japan. 9. Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Kanagawa, Japan. 10. Department of Pediatrics, Dokkyo Medical University, Mibu, Tochigi, Japan. 11. Department of Infection Control and Prevention, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan. 12. Fukuoka University, Fukuoka, Fukuoka, Japan. 13. Department of Breast Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan. 14. Department of Hematology, Oncology, Endocrinology and Infectious Disease, Fukuoka University, Fukuoka, Fukuoka, Japan. 15. Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
Abstract
PURPOSE: The Japanese Society of Medical Oncology published a guideline (GL) on febrile neutropenia (FN) in 2017. The study's purpose is to reveal how widely GL penetrated among physicians and surgeons providing chemotherapy. METHODS: A questionnaire survey was conducted with SurveyMonkey™ for members of the Japanese Association of Supportive Care in Cancer and relevant academic organizations. Each question had four options (always do, do in more than half of patients, do in less than half, do not at all) and a free description form. Responses were analyzed with statistical text-analytics. RESULT: A total of 800 responses were retrieved. Major respondents were experts with more than 10-year experience, physicians 54%, and surgeons 46%. Eighty-seven percent of respondents knew and used GL. Forty-eight percent assessed FN with Multinational Association of Supportive Care in Cancer (MASCC) score "always" or "more than half." Eighty-one percent chose beta-lactam monotherapy as primary treatment in high-risk patients. Seventy-seven percent did oral antibacterial therapy in low-risk patients ambulatorily. Seventy-eight percent administered primary prophylactic G-CSF (ppG-CSF) in FN frequency ≥ 20% regimen. Fifty-nine percent did ppG-CSF for high-risk patients in FN frequency 10-20% regimen. Ninety-seven percent did not use ppG-CSF in FN frequency < 10% regimen. The medians of complete and complete plus partial compliance rates were 46.4% (range 7.0-92.8) and 77.8% (range 35.4-98.7). The complete compliance rates were less than 30% in seven recommendations, including the MASCC score assessment. CONCLUSION: GL is estimated to be widely utilized, but some recommendations were not followed, presumably due to a mismatch with actual clinical practices in Japan.
PURPOSE: The Japanese Society of Medical Oncology published a guideline (GL) on febrile neutropenia (FN) in 2017. The study's purpose is to reveal how widely GL penetrated among physicians and surgeons providing chemotherapy. METHODS: A questionnaire survey was conducted with SurveyMonkey™ for members of the Japanese Association of Supportive Care in Cancer and relevant academic organizations. Each question had four options (always do, do in more than half of patients, do in less than half, do not at all) and a free description form. Responses were analyzed with statistical text-analytics. RESULT: A total of 800 responses were retrieved. Major respondents were experts with more than 10-year experience, physicians 54%, and surgeons 46%. Eighty-seven percent of respondents knew and used GL. Forty-eight percent assessed FN with Multinational Association of Supportive Care in Cancer (MASCC) score "always" or "more than half." Eighty-one percent chose beta-lactam monotherapy as primary treatment in high-risk patients. Seventy-seven percent did oral antibacterial therapy in low-risk patients ambulatorily. Seventy-eight percent administered primary prophylactic G-CSF (ppG-CSF) in FN frequency ≥ 20% regimen. Fifty-nine percent did ppG-CSF for high-risk patients in FN frequency 10-20% regimen. Ninety-seven percent did not use ppG-CSF in FN frequency < 10% regimen. The medians of complete and complete plus partial compliance rates were 46.4% (range 7.0-92.8) and 77.8% (range 35.4-98.7). The complete compliance rates were less than 30% in seven recommendations, including the MASCC score assessment. CONCLUSION: GL is estimated to be widely utilized, but some recommendations were not followed, presumably due to a mismatch with actual clinical practices in Japan.
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