不同剂量重组人粒细胞集落刺激因子对晚期卵巢癌化疗后骨髓抑制继发感染的预防

Effects of different doses of recombinant human granulocyte colony-stimulating factor on prevention of secondary infections induced by bone marrow suppression after chemotherapy for advanced ovarian cancer

目的探讨临床推荐重组人粒细胞集落刺激因子(rhG-CSF)的低剂量和高剂量使用,对晚期卵巢癌化疗后防治骨髓抑制引起的白细胞和中性粒细胞减少的作用。方法将113例晚期卵巢癌肿瘤减灭术后行TP静脉化疗方案的患者分为rhG-CSF低剂量组45例,予50μg/d,共240个化疗疗程;rhG-CSF高剂量组43例,予150μg/d,共232个化疗疗程;对照组25例,未使用rhG-CSF,共135个化疗疗程;观察化疗后白细胞及中性粒细胞动态变化及不良反应。结果化疗后第11天,rhG-CSF低剂量组和rhG-CSF高剂量组均出现白细胞计数平均最低值,而对照组则在化疗后第9天出现白细胞计数平均最低值;rhG-CSF低剂量组、rhG-CSF高剂量组、对照组的白细胞计数平均最低值分别为1.07×109/L、0.93×109/L和1.70×109/L,使用rhG-CSF后未见严重的不良反应。结论无论是低剂量还是高剂量使用rhG-CSF,均可在短时间内有效恢复晚期卵巢癌化疗后白细胞和中性粒细胞的水平,减少感染的发生。

OBJECTIVE To explore the effects of the high-dose and low-dose recombinant human granulocyte colony-stimulating factor （rhG-CSF） on prevention of leukopenia and neutropenia induced by bone marrow suppression after the chemotherapy for advanced ovarian cancer. METHODS A total of 113 advanced ovarian cancer patients who underwent TP venous chemotherapy after cytoreductive surgery were divided into the low-dose rhG-CSF group with 45 cases and the high-dose rhG-CSF group with 43 cases; the low-dose rhG-CSF group was treated with 50μg/d of rhG-CSF for totally 240 chemotherapy courses, and the high-dose rhG-CSF group was given 150μg/d of rhG-CSF for totally 232 chemotherapy courses; the control group wi.th 25 cases was not treated with rhG- CSF for totally 135 chemotherapy courses; the dynamic changes of white blood ceils and neutrophils and the incidence of adverse reactions were observed after the chemotherapy. RESULTS After the chemotherapy for 11 days, the average WBC counts were the lowest in both the low-dose rhG-CSF group and the high-dose rhC-CSF group; while, the average WBC counts were the lowest in the control group on the ninth day of chemotherapy; the lowest average WBC counts were 1.07×10^9/L in the low-dose rhG-CSF group, 0.93 ×10^9/L in the high-dose rhG-CSF group, 1.70 ×10^9/L in the control group. The severe adverse reactions did not occurred after the use of rhG-CSF. CONCLUSION Both the low-dose rhG-CSF and high-dose rhG-CSF can effectively make the levels of WBC and neutrophils of the patients with advanced ovarian cancer restored in a short term and reduce the incidence of infections.