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Table 1 Questions asked in the survey

From: Attitudes and practice patterns for maintaining relative dose intensity of chemotherapy in outpatient clinics: results of a Japanese web-based survey

Q. How old are you?
1. ≤29
2. 30–34
3. 35–39
4. 40–44
5. 45–49
6. 50–54
7. 55–59
8. ≥60
Q. In what decade did you receive your medical license?
1. 2000s
2. 1990s
3. 1980s
4. 1970s
Q. Please select one of the following to indicate your area of specialty.
(For Group ML)
1. Board-certified internist
2. Board-certified hematologist
3. Board-certified oncologist
4. Not applicable
(For Group BC)
1. Board-certified surgeon
2. Board-certified breast surgeon
3. Board-certified oncologist
4. Board-certified internist
5. Not applicable
Q. Please select one of the following to indicate your place of employment.
1. Academic medical center
2. Cancer center or public hospital
3. Private hospital
4. Other
Diffuse large B-cell lymphoma (DLBCL)
A 68-year-old woman was given a diagnosis of DLBCL, Stage IV A. There were hepatic metastases, but no bone marrow infiltration. She had no clinically significant past medical history. The International Prognostic Index was high-intermediate risk. Performance status (PS) was 0. Lactate dehydrogenase (LDH) was 1,250 IU/L. She was scheduled to receive six cycles of R-CHOP (rituximab 375 mg/m2 on day 1 or day 2, cyclophosphamide 750 mg/m2 on day 1, doxorubicin 50 mg/m2 on day 1, vincristine 1.4 mg/m2 on day 1 [max 2 mg], prednisone 100 mg on days 1–5) given every 21 days.
Breast cancer
A 68-year-old postmenopausal woman was given a diagnosis of right breast cancer, cT2N0M0 stage II A. She had no clinically significant past medical history. PS was 0. Right total mastectomy was performed. Pathological findings were as follows: pT 2.0 cm, grade 3, ly-, v-, pN1 (3/20), ER(-), PgR(-), HER2(-). She was scheduled to receive four cycles of TC (docetaxel 75 mg/m2 on day 1, cyclophosphamide 600 mg/m2 on day 1) given every 21 days.
Q1. Would you manage low-risk febrile neutropenia in patients such as those describe above on an inpatient or outpatient basis?
1. Outpatient
2. Inpatient
Q2. (For those who chose outpatient management) Which of the following choices do you feel most closely describes the treatment you usually provide to this type of patient?
1. Oral antibiotics only
2. Oral antibiotics and G-CSF
3. Observation
4. Other
Q3. (For those who chose inpatient management) Which of the following choices do you feel most closely describes the treatment you usually provide to this type of patient?
1. Intravenous antibiotics
2. Intravenous antibiotics and G-CSF
3. Other
[Clinical Course]
On the tenth day of the first cycle, she presented with a fever of 39 °C. A systematic review was unrevealing. Dietary and fluid intake was sufficient.
Blood pressure, 135/80 mmHg
HEENT: She had a clear oropharynx.
Chest: No rales or wheezes were present.
Cardiac: Normal S1 and S2. There was no murmur.
Abdomen: Soft and flat. Bowel sounds were normal.
Laboratory data: WBC:1,200/mm3, ANC:400/mm3, Hb:11.4 g/dL, PLT:158,000, GOT:23 IU/L, Alb:3.6 g/dL, BUN:18.8 mg/dL, Cr:0.6 mg/dL, CRP:1.8 mg/dL
Q4. How do you modify the dose of subsequent courses of chemotherapy after febrile neutropenia? Please select one of the following options.
1. Dose reduction is not required
2. Dose reduction is required if febrile neutropenia was treated by intravenous antibiotics
3. Dose reduction is required at any rate
4. Other
Q5. How do you use antibiotics for the subsequent course of chemotherapy after febrile neutropenia? Please select one of the following options.
1. Antimicrobial prophylaxis deserves consideration
2. Antibiotics should be taken into account when the next episode of febrile neutropenia occurs
3. I typically do not administer antibiotics
4. Other
Q6. How do you use G-CSF for the subsequent course of chemotherapy after febrile neutropenia? Please select one of the following options.
1. G-CSF prophylaxis deserves consideration
2. G-CSF should be taken into account when neutropenia occurs
3. G-CSF should be taken into account when the next episode of febrile neutropenia occurs
4. I typically do not administer G-CSF
5. Other
Q7. Regarding systems for managing adverse effects of outpatient chemotherapy, please check all appropriate responses.
1. Emergency outpatient unit is open at all hours
2. Clinical laboratory is open at all hours
3. Diagnostic imaging unit is open at all hours
4. Hospital antibiogram is available
5. Health professionals provide patient and family education
6. Chemotherapy telephone helpline is available
7. Not applicable