Cancer Center of Ehime University Hospital, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 7910295, Japan.
Int J Clin Oncol. 2011 Apr;16(2):118-24. doi: 10.1007/s10147-010-0134-x. Epub 2010 Oct 6.
In order to analyze the clinical activity and cost-effectiveness of granulocyte colony-stimulating factors (G-CSF), the prophylactic usage of G-CSF in patients treated with a single chemotherapy regimen during early courses was prospectively evaluated.
Thirty patients with newly diagnosed non-Hodgkin lymphoma (NHL) treated with the first course of an R-CHOP regimen were enrolled randomly. After treatment with the first course of chemotherapy, a daily dose of G-CSF (lenograstim, 100 μg) was administered to half (15 cases) of the patients, and a dose of G-CSF (100 μg) was administered every other day to the other half of the patients when leukocytopenia (<1.5 × 10(9)/L) and/or neutropenia (<0.5 × 10(9)/L) occurred. Changes in leukocyte and neutrophil counts, prophylaxis, febrile neutropenia (FN) events, and cost performance between the two groups were analyzed.
No significant difference between the two groups was observed in recoveries of leukocyte and neutrophil counts and evidence of FN. The only difference was the total cost of G-CSF.
We concluded that every-other-day use of G-CSF was as clinically effective for the prophylaxis of FN as the daily use of G-CSF, and economically speaking, the administration of G-CSF every other day should be more beneficial for patients with NHL during early courses of R-CHOP chemotherapy.
为了分析粒细胞集落刺激因子(G-CSF)的临床疗效和成本效益,前瞻性评估了在早期疗程中,单一化疗方案治疗的患者预防性使用 G-CSF 的情况。
随机纳入 30 例接受 R-CHOP 方案治疗的初诊非霍奇金淋巴瘤(NHL)患者。在接受第一疗程化疗后,一半(15 例)患者每天给予 G-CSF(lenograstim,100μg),另一半患者在白细胞减少症(<1.5×109/L)和/或中性粒细胞减少症(<0.5×109/L)时给予 G-CSF(100μg)隔日一次。分析两组白细胞和中性粒细胞计数变化、预防、发热性中性粒细胞减少症(FN)事件和成本效益。
两组白细胞和中性粒细胞计数恢复及 FN 证据无显著差异。唯一的区别是 G-CSF 的总费用。
我们得出结论,G-CSF 隔日使用与每日使用在预防 FN 方面具有相同的临床疗效,从经济学角度考虑,在 NHL 患者接受 R-CHOP 化疗早期,G-CSF 隔日给药更有利于患者。