G-CSF/GM-CSF序贯治疗宫颈癌化疗后骨髓抑制的效果及预后观察

Effectiveness and Prognosis of G-CSF/GM-CSF Sequential Therapy in treatment of Patients with Myelosuppression after Chemotherapy for Cervical Cancer

目的观察粒细胞集落刺激因子(G-CSF)/粒细胞-巨噬细胞集落刺激因子(GM-CSF)序贯治疗宫颈癌化疗后骨髓抑制的临床疗效及预后。方法回顾性分析2016年8月—2017年8月我院收治的宫颈癌化疗后出现骨髓抑制患者95例的临床资料。按照用药方法分为G/GM组52例和G组43例;G/GM组采用G-CSF/GM-CSF序贯给药,G组给予G-CSF单药。比较2组用药前及用药后第3、6、9、12、15 d血白细胞(WBC)、中性粒细胞(ANC)、血小板计数(PLT)。观察2组不良反应和1年生存率。结果2组用药后血WBC和ANC均呈先上升后下降趋势,G/GM组血WBC和ANC于第6 d达峰值,G组血WBC和ANC达峰值的时间分别为分别于12 d和9 d;G/GM组第6、9 d的血WBC和ANC高于G组(P<0.05)。G/GM组用药后PLT呈先上升后下降趋势,于第9 d达峰值;G组用药后PLT呈缓慢上升趋势;G/GM组第6、9 d的PLT高于G组(P<0.05)。2组不良反应和1年生存率比较差异无统计学意义(P>0.05)。结论G-CSF/GM-CSF序贯给药有助于提高治疗宫颈癌患者化疗后骨髓抑制的疗效,不良反应少,对预后无影响。

Objective To observe clinical effectiveness and prognosis of granulocyte colony-stimulating factor(G-CSF)/granulocyte-macrophage colony-stimulating factor(GM-CSF)sequential therapy in treatment of patients with myelosuppression after chemotherapy for cervical cancer.Methods Clinical data of 95 cervical cancer patients with myelosuppression during chemotherapy admitted during August 2016 and August 2017 was retrospectively analyzed,and the patients were divided into G/GM group(n=52)and G group(n=43)according to different medications.G/GM group was given G-CSF/GM-CSF sequential administration,while G group was given G-CSF single administration.In two groups,levels of blood white blood cells(WBC),absolute neutrophil count(ANC)and platelet count(PLT)in peripheral blood were compared before and on the 3 rd,6 th,9 th,12 th and 15 th d after administration,and incidence rate of adverse reactions and 1-year survival rate were observed.Results Levels of blood WBC and ANC in G/GM group increased first and then decreased.The peak values of WBC and ANC in GM group reached on the 6 th d after administration,while the peak times of WBC and ANC in G group were 12 th d and 9 th d after administration respectively.Levels of WBC and ANC on the 6 th and 9 th d after administration in GM group were significantly higher than those in G group(P<0.05).In G/GM group,PLT level increased first and then decreased,and its peak reached on the 9 th d after administration.In G group,PLT level increased slowly after treatment.PLT levels on the 6 th and 9 th d after administration in G/GM group were significantly higher than those in G group(P<0.05).There were no significant differences in incidence rate of adverse reactions and 1-year survival rate between two groups(P>0.05).Conclusion Sequential therapy of G-CSF/GM-CSF may help improve effectiveness of patients with myelosuppression after chemotherapy for cervical cancer with little adverse reactions without affecting prognosis of patients.