Hospitalizations for Chemotherapy-Induced Febrile Neutropenia in Patients with Lung Cancer in France from 2017 to 2020

OBJECTIVES: Febrile neutropenia (FN) is a severe complication of chemotherapy, associated with increased morbidity and mortality. This study aimed to estimate the clinical and economic burden of hospitalization for FN among cancer patients treated with chemotherapy in France. We focused on lung cancer, the most common cancer type associated with FN.

METHODS: Using a French nationwide hospital database (PMSI), we included all newly diagnosed patients receiving intravenous chemotherapy to treat lung cancer between January 2017 and November 2020 who were hospitalized for FN the month following their admission for chemotherapy during their first year of treatment. The number and characteristics of patients, as well as the number and length of stay, hospital cost, and inpatient mortality, are described.

RESULTS: The incidence of patients with lung cancer experiencing chemotherapy-induced FN slightly decreased from 3,050 (incidence rate of 10.8%) in 2017 to 2,725 (incidence rate of 9.4%) in 2020. Majority of patients with lung cancer and FN were male (68.7%), with a mean (SD) age of 66.7 (9.0) years in 2020. The in-hospital FN-related death rate was also constant at 16.4% in 2020. The number of stays for FN slightly decreased (2017: 3,802; 2020: 3,294 stays, whereas the average length of stay per patient remained stable with 10.5 days in 2020. The average costs rose from €5,305 to €5,539 per stay and per patient.

CONCLUSIONS: Although the proportion of French patients with lung cancer hospitalized for chemotherapy-induced FN decreased from 10.8% in 2017 to 9.4% in 2020, possibly because of the covid epidemy, the number of hospitalizations remained high, as did the proportion of in-hospital FN-related deaths. These figures highlight a real public health problem, and thus further research is needed for FN prevention.