PEG-rhG-CSF初级预防同步放化疗后中性粒细胞减少的有效性观察

Efficacy of pegylated recombinant human granulocyte colony stimulating factor(PEG-rhG-CSF)therapy in the primary prevention of concurrent chemoradiotherapy-induced neutropenia

目的评价聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)初级预防同步放化疗后中性粒细胞减少的有效性。方法开放、单臂临床观察天津医科大学肿瘤医院2018—2019年行同步放化疗的58例患者采用PEG-rhG-CSF初级预防同步放化疗后中性粒细胞减少的有效性。结果整个同步放化疗周期期间化疗延迟6例(10%),其中因白细胞或中性粒细胞减少导致化疗延迟3例(5%),化疗周期完成率为94.6%(106/112);放疗延迟10例(17%),其中因白细胞或中性粒细胞减少导致放疗延迟2例(3%)。中性粒细胞减少性发热(FN)发生率为0。亚组分析发现同步完成1周期化疗后,4级白细胞减少、中性粒细胞减少发生率均为0%;同步完成2周期化疗后4级白细胞减少、中性粒细胞减少发生率分别为0、2%。结论同步放化疗期间应用PEG-rhG-CSF初级预防可有效降低FN及4级白细胞、中性粒细胞减少发生率,利于同步放化疗顺利进行。

Objective To evaluate the efficacy and safety of pegylated recombinant human granulocyte colony stimulating factor(PEG-rhG-CSF)therapy in the primary prevention of concurrent chemoradiotherapy-induced neutropenia.Methods In this single-center,open-label,single-arm clinical observation,the efficacy of PEG-rhG-CSF in the primary prevention of neutropenia after concurrent chemoradiotherapy in 58 patients admitted to Tianjin Medical University Cancer Institute and Hospital from June 2018 to June 2019 was evaluated.Results During the whole concurrent chemoradiotherapy,chemotherapy delay occurred in 6 patients(10%).Three patients(5%)had delayed concurrent chemotherapy due to leukopenia or neutropenia.The completion rate of chemotherapy cycle was 94.6%(106/112).Radiotherapy delay occurred in 10 patients(17%)including 2 patients(3%)of delayed radiotherapy due to leukopenia or neutropenia.No patient developed febrile neutropenia(FN).Subgroup analysis found that after completing 1 cycle of concurrent chemoradiotherapy,the incidence rates of grade 4 leukopenia and neutropenia were both 0.After completing 2 cycles of concurrent chemoradiotherapy,the incidence rates of grade 4 leukopenia and neutropenia were 0 and 2%.Conclusion During the chemoradiotherapy,application of PEG-rhG-CSF in the primary preventation can significantly reduce the incidence of FN,grade 4 leukopenia and neutropenia,which is beneficial to ensure the smooth progress of concurrent chemoradiotherapy.