Lee Jihyoun, Lee Jong Eun, Kim Zisun, Han Sun Wook, Hur Sung Mo, Kim Sung Yong, Lee Min Hyuk, Lim Cheol Wan
Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Ann Surg Treat Res. 2018 May;94(5):223-228. doi: 10.4174/astr.2018.94.5.223. Epub 2018 Apr 30.
Primary prophylaxis with granulocyte colony-stimulating factor can effectively prevent febrile neutropenia (FN) during breast cancer treatment. The aims of this study were to evaluate the incidence of FN and the ANC profile in patients undergoing chemotherapy and pegfilgrastim primary prophylaxis.
Patients receiving 6 cycles of adjuvant docetaxel, doxorubicin, and cyclophosphamide (TAC) chemotherapy were included in this study. Pegfilgrastim was administered with analgesics 24 hours after treatment. Laboratory tests were performed on day 0 (before chemotherapy) and ANC was measured daily starting day 5 until it were restored to 1,000/mm. Bone pain was checked via the numeral rating scale (NRS).
A total of 61 patients and 366 cycles were evaluated. Mean age was 49.2 ± 7.1 years. FN was seen in 5 patients (16.4%) and 12 cycles (3.3%) with pegfilgrastim. Grades 3 and 4 neutropenia was seen in 91.5% of cycles with FN. The ANC nadir was most commonly seen at day 7 and the mean ANC nadir depth was 265.7/m. Age was negatively correlated with nadir depth (r = -0.137, P = 0.009). Severe pain higher than NRS 7 occurred in less than 20% of patients after the administration of pegfilgrastim.
Incidence of FN was low during the chemotherapy by primary prophylaxis with pegfilgrastim. The ANC nadir was seen on day 7 after chemotherapy. Bone pain with pegfilgrastim was well tolerated during TAC chemotherapy.
使用粒细胞集落刺激因子进行一级预防可有效预防乳腺癌治疗期间的发热性中性粒细胞减少症（FN）。本研究的目的是评估接受化疗和聚乙二醇化重组人粒细胞刺激因子一级预防的患者中FN的发生率和中性粒细胞绝对值（ANC）情况。
本研究纳入接受6个周期辅助多西他赛、阿霉素和环磷酰胺（TAC）化疗的患者。治疗后24小时给予聚乙二醇化重组人粒细胞刺激因子及镇痛药。在第0天（化疗前）进行实验室检查，并从第5天开始每日测量ANC，直至其恢复至1000/mm³。通过数字评定量表（NRS）检查骨痛情况。
共评估61例患者和366个周期。平均年龄为49.2±7.1岁。使用聚乙二醇化重组人粒细胞刺激因子时，5例患者（16.4%）和12个周期（3.3%）出现FN。FN的周期中有91.5%出现3级和4级中性粒细胞减少。ANC最低点最常见于第7天，平均ANC最低点深度为265.7/mm³。年龄与最低点深度呈负相关（r = -0.137，P = 0.009）。给予聚乙二醇化重组人粒细胞刺激因子后，不到20%的患者出现高于NRS 7的严重疼痛。
聚乙二醇化重组人粒细胞刺激因子一级预防化疗期间FN的发生率较低。化疗后第7天出现ANC最低点。在TAC化疗期间，聚乙二醇化重组人粒细胞刺激因子引起的骨痛耐受性良好。
