聚乙二醇化重组人粒细胞刺激因子在骨肉瘤患者初次吡柔比星联合顺铂方案化疗后的临床疗效

The effect of pegylated recombinant human granulocyte stimulating factor on chemotherapy-naïve osteosarcoma patients after pirarubicin and cisplatin treatment

目的评估聚乙二醇重组人粒细胞刺激因子(polyethylene glycolated recombinant human gran-ulocyte stimulating factor,PEG-rhG-CSF)预防骨肉瘤患者初次吡柔比星联合顺铂方案化疗后引起的中性粒细胞绝对数(absolute neutrophil count,ANC)减少的临床效果。方法纳入初诊为骨肉瘤的患者77例为研究对象。根据化疗后是否预防性应用PEG-rhG-CSF将其分为对照组(rhG-CSF组)25例、观察组(PEG-rhG-CSF联合rhG-CSF组)52例。患者初次化疗方案均为AP方案。通过定期观测血常规评估化疗后ANC减少及预防性应用PEG-rhG-CSF的效果。结果预防性应用PEG-rhG-CSF可以显著缩短ANC减少的持续时间,降低Ⅲ-Ⅳ级ANC减少和粒细胞减少性发热(febrile neutropenia,FN)的发生率,减少补充使用rhG-CSF的使用剂量和时间,同时减少了抗生素的使用时间(P<0.05)。结论预防性应用PEG-rhG-CSF可以有效的降低吡柔比星联合顺铂方案化疗后ANC减少的发生,且安全性良好。有益于保证骨肉瘤患者后续大剂量、高强度化疗的顺利进行。

Objective To investigate the prevention efficiency of Pegylated recombinant human granulocyte stimulating factor(PEG-rhG-CSF)on chemotherapy-naïve osteosarcoma patients treated by pirarubicin and cisplatin.Methods 77 chemotherapy-naïve osteosarcoma patients were enrolled for the study.The patients were non-randomly divided into a control group(rh-CSF group)with 25 patients and an experiment group(rhG-CSF combined with PEG-rhG-CSF group)with 52 patients,according to whether they received PEG-rhG-CSF after AP chemotherapy.The prevention effect of PEG-rhG-CSF on reduction of neutrophils after chemotherapy were evaluated.Results Prophylaxis of PEG-rhG-CSF significantly reduced the incidence of Ⅲ-Ⅳ degree of ANC reduction,shorten the duration of ANC reduction,decreased the dosage and days of supplemental usage of rhG-CSF,reduced the incidence of FN and shorten the days of antibiotic usage(all P<0.05).Conclusion Prophylaxis of PEG-rhG-CSF can effectively prevent the occurrence and duration of neutropenia with good safety.It is beneficial to ensure the following high-dose and high-intensity chemotherapy for osteosarcoma patients.