论聚乙二醇化重组人粒细胞刺激因子防治肺癌患者化疗相关性粒细胞减少的疗效

Effect of pegylated recombinant human granulocyte stimulating factor on chemotherapy-related granulocytopenia in patients with lung cancer

目的研究聚乙二醇化重组人粒细胞刺激因子(PEG-rhG-CSF)在预防肺癌患者化疗相关性白细胞及中性粒细胞减少方面的疗效。方法此研究为随机对照研究,选取2019年10月-2021年9月复旦大学附属肿瘤医院闵行分院肿瘤内科收治的62例采取含铂双药方案化疗且第1个疗程后出现Ⅱ°-Ⅳ°白细胞(WBC)或中性粒细胞(ANC)减少的肺癌患者,随机分为两组,每组31例患者,试验组在每个疗程结束后48h皮下注射6mg PEG-rhG-CSF,对照组化疗后密切随访血常规,观察两组患者WBC及ANC动态变化,若出现WBC或ANC减少,均予重组人粒细胞刺激因子(rhG-CSF,5μg/kg,皮下注射,每天1次)升白治疗至WBC>10.0×10^(9)/L,并且ANC>2.0×10^(9)/L停止用药,比较两组疗效与安全性。结果试验组预防性应用PEG-rhG-CSF后,化疗第6、8、20天WBC及ANC显著高于对照组,WBC及ANC最小值均明显高于对照组,并且rhG-CSF应用时间明显缩短。对照组出现Ⅱ°-Ⅳ°WBC或ANC减少12例(38.7%)。乏力22例(71.0%)、FN7例(22.6%)、继发感染6例(19.4%)、化疗延迟16例(51.6%),均明显高于试验组。两组骨髓生长因子的主要副反应均为骨骼疼痛,发生率差异无统计学意义。结论应用PEG-rhG-CSF进行升白预防,能够显著降低肺癌患者化疗相关性Ⅲ°-Ⅳ°WBC、ANC减少和FN的发生率,保证化疗按时、足量进行。

Objective To study the efficacy of PEGylated recombinant human granulocyte stimulating factor in preventing chemotherapy-related leukopenia and neutropenia in patients with lung cancer.Methods This study is a randomized controlled study.From October 2019 to September 2021,62 patients who were admitted to the Department of Oncology,Minhang Branch of Fudan University Cancer Hospital were treated with platinum-containing dual-drug chemotherapy and Ⅱ°-Ⅳ°white blood cells appeared after the first course of treatment.Patients with lung cancer or neutropenia were randomly divided into 2 groups,each with 31 patients.The experimental group was injected with 6mg of PEGylated recombinant human granulocyte stimulating factor 48 hours after the end of each course of treatment,and the control group after chemotherapy Follow up blood routine closely to observe the dynamic changes of white blood cells and neutrophils in the two groups of patients.If leukocytes or neutrophils decrease,they will he given recombinant human granulocyte stimulating factor(5ug/kg,subcutaneous injection,once a day).After white treatment,the white blood cell>10.0×10^(9)/L and the neutrophil granulocyte>2.0×10^(9)/L were stopped.The efficacy and safety of the two groups were compared.Resu I ts After prophylactic application of PEGylated recombinant human granulocyte stimulating factor in the experimental group,the white blood cells and neutrophils on the 6,8,and 20 days of chemotherapy were significantly higher than those of the control group,and the minimum values of white blood cells and neutrophils were significantly higher than those in the control group.In the control group,the application time of recombinant human granulocyte stimulating factor was significantly shortened.In the control group,12 cases(38.7%)of 2-4 leukopenia or neutrophils,asthenia in 22 cases(71.0%),7 cases(22.6%)with agranulocytosis and fever,and 6 cases(19.4%)with secondary infection.Chemotherapy was delayed in 16 cases(51.6%),which were significantly higher than those in the experimental group.The main side effects of bone marrow growth factor between the two groups were hone pain,and the difference in incidence was not statistically significant.Cone I us i on The use of PEGylated recombinant human granulocyte stimulating factor for whitening prevention can significantly reduce the incidence of chemotherapy-related Ⅲ°-Ⅳ°white blood cells,neutropenia,and agranulocytosis in lung cancer patients with fever,and ensure that chemotherapy is on time and Carry out adequately.