Prise en charge des neutropénies fébriles au cours du cancer bronchique

Febrile neutropenia remains a major complication of the chemotherapies used in treating lung cancer. The frequent association of COPD and lung cancer warrants hospitalization during these episodes. The frequency and the potential gravity of bacterial infections requires early probabilistic antibiotic therapy. The choice is based on knowledge of the epidemiology and the local profile of bacterial resistance, the presence of severity criteria and risk factors associated with the onset of severe infection. The time to achieving apyrexia and the end of aplasia condition the modifications and duration of the antibiotic therapy. Growth factors and antibiotic therapy are not recommended in daily practice for the prevention of febrile neutropenia episodes in non-small-cell lung cancers, but are discussed for small-cell lung cancers treated with platinum-based chemotherapies, cyclophosphamide, doxorubicin, and etoposide.