Bronchud M H, Howell A, Crowther D, Hopwood P, Souza L, Dexter T M
Cancer Research Campaign Department of Medical Oncology, Paterson Institute for Cancer Research, Christie Hospital and Holt Radium Institute, Manchester, UK.
Br J Cancer. 1989 Jul;60(1):121-5. doi: 10.1038/bjc.1989.234.
Granulocyte colony stimulating factor (G-CSF) was given to 17 patients with advanced breast and ovarian cancer in order to increase the intensity and effectiveness of chemotherapy. Treatment with doxorubicin, at doses of 75 mg m-2 (n = 4 patients), 100 mg m-2 (n = 5), 125 mg m-2 (n = 6) and 150 mg m-2 (n = 2), was followed by infusion of G-CSF for 11 days. G-CSF administration resulted in a return of the absolute neutrophil count to normal or above normal levels within 12-14 days at all dose levels of doxorubicin used and allowed the administration of up to three cycles of high dose chemotherapy at 14 day intervals. An absolute neutrophil count greater than 2.5 x 10(9)l-1 was not reached until day 19-21 after 75 mg m-2 of doxorubicin given without G-CSF. At doses of doxorubicin of 125 mg m-2 and 150 mg m-2 all tumours regressed rapidly, although there was marked epithelial toxicity. The overall response rate in patients with advanced breast cancer was 80% with a median time to progression of 6 months. Two months after doxorubicin-G-CSF therapy there was a pronounced improvement of symptoms compared with before treatment. Thus the effectiveness of chemotherapy may be enhanced and treatment duration shortened by the use of G-CSF infusions. Further studies of this promising approach are warranted.
为提高化疗强度和疗效，对17例晚期乳腺癌和卵巢癌患者给予粒细胞集落刺激因子（G-CSF）。采用阿霉素治疗，剂量分别为75mg/m²（4例患者）、100mg/m²（5例）、125mg/m²（6例）和150mg/m²（2例），随后输注G-CSF 11天。在所有使用的阿霉素剂量水平下，G-CSF给药均使绝对中性粒细胞计数在12 - 14天内恢复至正常或高于正常水平，并允许每14天进行多达三个周期的高剂量化疗。在未给予G-CSF的情况下，给予75mg/m²阿霉素后，直到第19 - 21天才达到大于2.5×10⁹/L的绝对中性粒细胞计数。在阿霉素剂量为125mg/m²和150mg/m²时，所有肿瘤均迅速消退，尽管存在明显的上皮毒性。晚期乳腺癌患者的总体缓解率为80%，中位进展时间为6个月。与治疗前相比，阿霉素 - G-CSF治疗两个月后症状有明显改善。因此，使用G-CSF输注可提高化疗效果并缩短治疗时间。这种有前景的方法值得进一步研究。
