Department of Pharmacy, University Hospital, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
Outpatient Oncology Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Med Oncol. 2018 Mar 16;35(4):55. doi: 10.1007/s12032-018-1116-5.
Although pegfilgrastim prophylaxis is expected to maintain the relative dose intensity (RDI) of chemotherapy and improve safety, information is limited. However, the optimal selection of patients eligible for pegfilgrastim prophylaxis is an important issue from a medical economics viewpoint. Therefore, this retrospective study identified factors that could predict these eligible patients to maintain the RDI. The participants included 166 cancer patients undergoing pegfilgrastim prophylaxis combined with chemotherapy in our outpatient chemotherapy center between March 2015 and April 2017. Variables were extracted from clinical records for regression analysis of factors related to maintenance of the RDI. RDI was classified into four categories: 100% = 0, 85% or < 100% = 1, 60% or < 85% = 2, and < 60% = 3. Multivariate ordered logistic regression analysis was performed to identify predictive factors in patients eligible for pegfilgrastim prophylaxis to maintain the RDI. Threshold measures were examined using a receiver operating characteristic (ROC) analysis curve. Age [odds ratio (OR) 1.07, 95% confidence interval (CI) 1.04-1.11; P < 0.0001], anemia (grade) (OR 1.77, 95% CI 1.10-2.84; P = 0.0184), and administration 24-72 h after chemotherapy (OR 0.44, 95% CI 0.22-0.89; P = 0.0224) were factors that significantly correlated with RDI maintenance. ROC curve analysis of the group that failed to maintain the RDI indicated that the threshold for age was 70 years and above, with a sensitivity of 60.0% and specificity of 80.2% (area under the curve: 0.74). In conclusion, younger age, anemia (less), and administration of pegfilgrastim 24-72 h after chemotherapy were significant factors for RDI maintenance.
虽然培非格司亭预防治疗预计能维持化疗的相对剂量强度（RDI）并提高安全性，但相关信息有限。然而，从医疗经济学的角度来看，选择合适的接受培非格司亭预防治疗的患者是一个重要问题。因此，本回顾性研究旨在确定可预测这些有资格接受培非格司亭预防治疗的患者维持 RDI 的因素。参与者包括 2015 年 3 月至 2017 年 4 月在我们的门诊化疗中心接受培非格司亭预防治疗联合化疗的 166 名癌症患者。从临床记录中提取变量，进行回归分析以确定与维持 RDI 相关的因素。RDI 分为四类：100%=0、85%或<100%=1、60%或<85%=2、<60%=3。采用多变量有序逻辑回归分析识别有资格接受培非格司亭预防治疗以维持 RDI 的患者的预测因素。使用受试者工作特征（ROC）分析曲线检查阈值测量值。年龄[比值比（OR）1.07，95%置信区间（CI）1.04-1.11；P<0.0001]、贫血（等级）（OR 1.77，95%CI 1.10-2.84；P=0.0184）和化疗后 24-72 小时给药（OR 0.44，95%CI 0.22-0.89；P=0.0224）是与 RDI 维持显著相关的因素。未能维持 RDI 组的 ROC 曲线分析表明，年龄的阈值为 70 岁及以上，敏感性为 60.0%，特异性为 80.2%（曲线下面积：0.74）。结论：年龄较小、贫血（较轻）和化疗后 24-72 小时给予培非格司亭是 RDI 维持的重要因素。
