Table 1 Questions asked in the 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 |