Freyer G, Ligneau B, Trillet-Lenoir V
Medical Oncology Unit, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.
Int J Antimicrob Agents. 1998 Apr;10(1):3-9. doi: 10.1016/s0924-8579(98)00016-8.
Haematologic toxicity and its most frequent complication, febrile neutropenia represents the main limiting factor to the use of anti-cancer chemotherapy. The recent availability of recombinant human colony stimulating factors offers a new opportunity to improve the tolerance of these treatments. Most randomized trials in various solid tumors have demonstrated the ability of granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor to significantly reduce the incidence of febrile neutropenia and related complications. Interestingly enough, these compounds are well tolerated and easy to administrate. However, since the increase in dose-intensity does not translate into any improved efficacy in terms of response rates or survival, the use of colony-stimulating factors has to be decided on the basis of cost-benefit considerations. Therefore, some scientific societies such as the American Association of Clinical Oncology in the US and the Anti-Cancer Centers Group in France have published recommendations for their use in routine oncology practice. We here discuss these guidelines on the basis of an overview of the literature.
血液学毒性及其最常见的并发症发热性中性粒细胞减少是抗癌化疗应用的主要限制因素。重组人集落刺激因子的近期可得性为提高这些治疗的耐受性提供了新机会。各种实体瘤的大多数随机试验已证明粒细胞集落刺激因子和粒细胞巨噬细胞集落刺激因子能够显著降低发热性中性粒细胞减少及其相关并发症的发生率。有趣的是，这些化合物耐受性良好且易于给药。然而，由于剂量强度的增加在缓解率或生存率方面并未转化为任何疗效改善，因此必须基于成本效益考虑来决定是否使用集落刺激因子。因此，一些科学协会，如美国临床肿瘤学会和法国抗癌中心组织，已发布了在常规肿瘤学实践中使用它们的建议。我们在此根据文献综述讨论这些指南。
