Schippinger Walter, Holub Robert, Dandachi Nadia, Bauernhofer Thomas, Samonigg Hellmut
Division of Medical Oncology, Department of Internal Medicine, Medical University Graz, Graz, Austria.
Oncology. 2006;70(4):290-3. doi: 10.1159/000094890. Epub 2006 Aug 4.
Recombinant granulocyte colony-stimulating factors (G-CSF) have been shown to be effective in reducing the risk of infections associated with antitumour chemotherapy. This report describes a single-centre experience of the efficacy of pegfilgrastim compared with filgrastim or lenograstim in reducing the incidence of febrile neutropenia in patients receiving combination chemotherapy with taxane and epirubicin in a neoadjuvant and adjuvant setting.
A total of 118 patients with breast cancer were treated with either epirubicin 75 mg/m(2) and docetaxel 75 mg/m(2) or epirubicin 90 mg/m(2) and paclitaxel 200 mg/m(2) every 3 weeks; 88 received G-CSF support with daily filgrastim or lenograstim and 30 with pegfilgrastim once per cycle.
Eight patients (9.1%) with prophylactic filgrastim or lenograstim support developed febrile neutropenia, as well as 1 patient (3.3%) in the pegfilgrastim group (p = 0.445). Febrile neutropenia occurred in 13 (2.7%) of 476 filgrastim or lenograstim supported chemotherapy cycles and in 2 (1.2%) of 172 cycles with pegfilgrastim support (p = 0.376). The frequency of chemotherapy delays and dose reductions was not significantly different between the two G-CSF treatment groups.
These data show a trend towards superiority of pegfilgrastim over filgrastim or lenograstim in reducing the frequency of febrile neutropenia in patients treated with taxane and epirubicin chemotherapy regimens for breast cancer.
重组粒细胞集落刺激因子(G-CSF)已被证明可有效降低与抗肿瘤化疗相关的感染风险。本报告描述了在新辅助和辅助治疗中,聚乙二醇化重组人粒细胞刺激因子与非格司亭或来格司亭相比,在接受紫杉烷和表柔比星联合化疗的患者中降低发热性中性粒细胞减少发生率的单中心经验。
共有118例乳腺癌患者接受每3周一次的表柔比星75mg/m²和多西他赛75mg/m²或表柔比星90mg/m²和紫杉醇200mg/m²治疗;88例接受G-CSF支持,每日使用非格司亭或来格司亭,30例每周期使用一次聚乙二醇化重组人粒细胞刺激因子。
接受预防性非格司亭或来格司亭支持的8例患者(9.1%)发生了发热性中性粒细胞减少,聚乙二醇化重组人粒细胞刺激因子组有1例患者(3.3%)发生(p = 0.445)。在476个接受非格司亭或来格司亭支持的化疗周期中,有13个(2.7%)发生发热性中性粒细胞减少,在172个接受聚乙二醇化重组人粒细胞刺激因子支持的周期中有2个(1.2%)发生(p = 0.376)。两个G-CSF治疗组之间化疗延迟和剂量减少的频率没有显著差异。
这些数据表明,在接受紫杉烷和表柔比星化疗方案治疗乳腺癌的患者中,聚乙二醇化重组人粒细胞刺激因子在降低发热性中性粒细胞减少频率方面有优于非格司亭或来格司亭的趋势。