Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China.
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
BMJ Support Palliat Care. 2019 Dec;9(4):373-380. doi: 10.1136/bmjspcare-2019-001862. Epub 2019 Aug 29.
This study explored the prophylactic effects of long-acting granulocyte colony-stimulating factor (G-CSF) for febrile neutropenia (FN) in newly diagnosed patients with epithelial ovarian cancer (EOC).
Patients were randomised into a study group (long-acting G-CSF for all chemotherapy cycles) and a control group (short-acting G-CSF for first cycle and treatment per physician discretion for subsequent cycles) at a ratio of 1:2. The incidences of FN and myelosuppression and the number of clinical visits, medication doses, complete blood count (CBC) tests and adverse events were compared between the two groups. A regression model was used to determine the risk factors for FN.
From 30 November 2018 to 1 April 2019, 84 cases were included in the final analysis; there were 24 (28.6%) and 60 (71.4%) patients in the study and control groups, respectively, and 605 chemotherapy cycles. The study group or chemotherapy cycles utilising long-acting G-CSF had significantly fewer utilisations and doses of short-acting G-CSF; clinical visits; CBC tests; and incidences of FN and myelosuppression; and less G-CSF-associated pain. The utilisation of G-CSF was the only independent factor for FN in a binary regression model.
Long-acting G-CSF could effectively reduce the incidences of FN and myelosuppression and had mild adverse effects in newly diagnosed patients with EOC receiving chemotherapy.
NCT03740464.
本研究旨在探讨长效粒细胞集落刺激因子（G-CSF）预防初诊上皮性卵巢癌（EOC）患者化疗后发热性中性粒细胞减少症（FN）的效果。
患者按 1:2 的比例随机分为研究组（所有化疗周期均使用长效 G-CSF）和对照组（第 1 周期使用短效 G-CSF，随后周期根据医生判断使用）。比较两组 FN 和骨髓抑制的发生率、就诊次数、药物剂量、全血细胞计数（CBC）检查次数和不良反应发生情况。采用回归模型确定 FN 的危险因素。
2018 年 11 月 30 日至 2019 年 4 月 1 日，最终纳入 84 例患者进行分析，研究组和对照组各 24 例（28.6%）和 60 例（71.4%），共 605 个化疗周期。研究组或化疗周期使用长效 G-CSF 时，短效 G-CSF 的使用次数和剂量、就诊次数、CBC 检查次数、FN 和骨髓抑制发生率以及 G-CSF 相关疼痛均显著减少。在二项回归模型中，G-CSF 的使用是 FN 的唯一独立因素。
长效 G-CSF 可有效降低初诊 EOC 患者化疗后 FN 和骨髓抑制的发生率，且不良反应轻微。
NCT03740464。
