Ku Minhee, Je Nam Kyung
College of Pharmacy, Pusan National University, Busan, Republic of Korea.
Department of Pharmacy, Dongnam Institute of Radiological & Medical Sciences, Busan, Republic of Korea.
J Chemother. 2022 Dec;34(8):534-542. doi: 10.1080/1120009X.2021.2009988. Epub 2021 Dec 6.
Docetaxel/cyclophosphamide (TC) is a widely used adjuvant chemotherapy regimen, especially in patients with node-negative or low-risk node-positive breast cancer. Guidelines recommend the use of prophylactic granulocyte colony-stimulating factor (G-CSF) to prevent febrile neutropenia. In this study, we aimed to explore the use of G-CSF as a primary prophylactic and determine the factors influencing its use. This retrospective study used nationwide claims data from the National Inpatient Sample compiled by the Health Insurance Review and Assessment Service in South Korea from 2018. The claims data included 10% of inpatients admitted at least once in 2018 and 1% of outpatients who were not admitted. Female patients with breast cancer who received an adjuvant TC regimen after surgery were selected. Primary prophylactic G-CSF was defined as G-CSF prescribed within two days of the first cycle of TC. The factors influencing its utilisation were investigated using the chi-square test and a multiple logistic regression model. A total of 229 patients were included in the analysis. The proportion of patients who received primary prophylactic G-CSF treatment after the first cycle of TC was 55.5%. The factors positively influencing G-CSF utilization were patients' age ≥65 years, location (i.e. metropolitan areas), and the type of healthcare facility (i.e. non-tertiary hospitals). The use of prophylactic G-CSF in patients with breast cancer who received the adjuvant TC regimen was insufficient. The use of primary G-CSF prophylaxis should be emphasised to reduce the risk of febrile neutropenia among patients receiving a myelosuppressive TC regimen.
多西他赛/环磷酰胺（TC）是一种广泛应用的辅助化疗方案，尤其适用于腋窝淋巴结阴性或低风险腋窝淋巴结阳性的乳腺癌患者。指南推荐使用预防性粒细胞集落刺激因子（G-CSF）来预防发热性中性粒细胞减少。在本研究中，我们旨在探讨G-CSF作为一级预防措施的使用情况，并确定影响其使用的因素。这项回顾性研究使用了韩国健康保险审查和评估服务机构汇编的2018年全国住院患者样本中的全国索赔数据。索赔数据包括2018年至少住院一次的10%的住院患者和未住院的1%的门诊患者。选择术后接受辅助TC方案的女性乳腺癌患者。一级预防性G-CSF定义为在TC第一个周期的两天内开具的G-CSF。使用卡方检验和多元逻辑回归模型研究影响其使用的因素。共有229例患者纳入分析。TC第一个周期后接受一级预防性G-CSF治疗的患者比例为55.5%。对G-CSF使用有积极影响的因素包括患者年龄≥65岁、地区（即大城市地区）和医疗机构类型（即非三级医院）。接受辅助TC方案的乳腺癌患者预防性G-CSF的使用不足。应强调使用一级G-CSF预防措施，以降低接受骨髓抑制性TC方案的患者发生发热性中性粒细胞减少的风险。
