Danova Marco, Rosti Giovanni, De Placido Sabino, Bencardino Katia, Venturini Marco
Medical Oncology, Flow Cytometry and Cell Therapy Unit, IRCCS S. Matteo University Hospital, I-27100 Pavia, Italy.
Oncol Rep. 2005 Dec;14(6):1405-12.
In October 2003, the Italian Association of Medical Oncology (AIOM) published its own guidelines on the use of granulocyte colony-stimulating factor (G-CSF). The present survey was conducted during the same period with the aim of collecting data on the current use of G-CSF to provide a starting point for future evaluations of the implementation of AIOM guidelines. From October 2003 to January 2004, 1591 AIOM members were asked to complete a questionnaire based on specific clinical scenarios, regarding the use of G-CSF for primary and secondary prophylaxis and treatment of neutropenia. The rate of response was 22%. For primary prophylaxis, the majority of physicians avoid using G-CSF, with no difference in cases of adjuvant, curative or palliative chemotherapy (CT). In fact, 67.2% to 74.9% would 'rarely or never' use G-CSF in the proposed clinical scenarios. In chemosensitive tumors, rather than reducing CT doses, 55.7% would use G-CSF as a secondary prophylaxis after afebrile neutropenia (AN), and 68.8% after febrile neutropenia (FN). In elderly patients experiencing FN, 35.7% would reduce the adjuvant CT doses and 23.1% would change the regimen. Most oncologists would use G-CSF to treat neutropenia, and the median duration of G-CSF treatment is less than 1 week and would depend on neutrophil count. Our survey shows that Italian oncologists are particularly oriented towards the use of G-CSF in clinical practice to maintain the CT dose intensity, and are sensitive to the prevention and treatment of not only FN, but also AN. Finally, Italian medical oncologists appear to be very cautious in introducing G-CSF when treating elderly patients.
2003年10月，意大利医学肿瘤学会（AIOM）发布了关于使用粒细胞集落刺激因子（G-CSF）的指南。同期开展了本次调查，目的是收集G-CSF当前使用情况的数据，为未来评估AIOM指南的实施提供一个起点。2003年10月至2004年1月，1591名AIOM成员被要求根据特定临床场景完成一份关于使用G-CSF进行中性粒细胞减少症一级和二级预防及治疗的问卷。回复率为22%。对于一级预防，大多数医生避免使用G-CSF，在辅助、根治性或姑息性化疗（CT）病例中无差异。事实上，在建议的临床场景中，67.2%至74.9%的医生“很少或从不”使用G-CSF。在化疗敏感肿瘤中，55.7%的医生会在无发热性中性粒细胞减少症（AN）后将G-CSF用作二级预防，68.8%的医生会在发热性中性粒细胞减少症（FN）后使用。在发生FN的老年患者中，35.7%的医生会降低辅助CT剂量，23.1%的医生会改变治疗方案。大多数肿瘤学家会使用G-CSF治疗中性粒细胞减少症，G-CSF治疗的中位持续时间少于1周，且取决于中性粒细胞计数。我们的调查表明，意大利肿瘤学家在临床实践中特别倾向于使用G-CSF以维持CT剂量强度，并且不仅对FN的预防和治疗敏感，对AN也敏感。最后，意大利医学肿瘤学家在治疗老年患者时引入G-CSF似乎非常谨慎。
