聚乙二醇化重组人粒细胞刺激因子预防卵巢上皮性癌多柔吡星联合卡铂化疗后粒细胞减少症的临床疗效及安全性

Efficacy and safety of PEG⁃rhG⁃CSF for preventing neutropenia after chemotherapy with doxorubicin plus carboplatin in epithelial ovarian cancer patients:A retrospective clinical study

目的评价聚乙二醇化重组人粒细胞刺激因子(Pegylated recombinant human granulocyte colony stimulating factor,PEG-rhG-CSF)在预防卵巢上皮性癌患者多柔吡星联合卡铂(AC)方案化疗后中性粒细胞减少症的价值。方法回顾性分析南方医科大学南方医院妇产科接受AC方案化疗的卵巢上皮性癌患者136例,化疗后预防性使用了PEG-rhG-CSF的病例为观察组(87例),未使用PEG-rhGCSF的病例为对照组(49例)。采用独立样本t检验、方差分析或者χ2检验对比两组化疗前后中性粒细胞减少症、发热性中性粒细胞减少的发生率、肝肾功能、QOL-C30生活质量评估等指标。结果观察组的3~4级中性粒细胞减少症、发热性中性粒细胞减少的发生率比对照组更低(5.5%vs.15.9%,0.8%vs.2.8%),差异均有统计学意义(P<0.001);观察组和对照组的肝肾功能损害发生率差异无统计学意义(3.4%vs.4.0%,P>0.05);两组未发生严重不良反应(P>0.05);生活质量评估分析发现观察组功能领域评分及总体健康状况评分高于对照组[(67.89±13.95)vs.(50.22±15.17);(68.05±17.09)vs.(48.74±20.18)],差异有统计学意义(P<0.05)。结论PEG-rhG-CSF预防卵巢上皮性癌AC方案化疗后中性粒细胞减少症有较高的有效性及安全性,不良反应轻微,能提高卵巢上皮性癌AC方案化疗患者生活质量。

Objective Evaluate the value of PEG-rhG-CSF in preventing neutropenia in ovarian epithelial cancer patients after AC regimen chemotherapy.Method A retrospective analysis was conducted on 136 patients with ovarian epithelial cancer who received AC regimen chemotherapy at the Department of Obstetrics and Gynecol⁃ogy,Southern Medical University Nanfang Hospital.The observation group consisted of 87 patients who received prophylactic use of PEG-rhG-CSF after chemotherapy,while the control group consisted of 49 patients who did not use PEG-rhG-CSF.The independent sample T-test,analysis of variance,and Chi-square test were used to compare the differences in neutropenia,neutropenic fever,QOL-C30,liver and kidney function between the two groups.Results The incidence of grade 3-4 neutropenia and febrile neutropenia in the observation group was lower than that in the control group(5.5%vs.15.9%,0.8%vs.2.8%),and the differences were statistically significant(P<0.001);There was no statistically significant difference in the incidence of liver and kidney function damage between the observation group and the control group(3.4%vs.4.0%,P>0.05).No serious adverse reactions occurred between the two groups(P>0.05).Quality of life assessment analysis found that the functional area score and overall health status score of the observation group were higher than those of the control group(67.89±13.95 vs.50.22±15.17,68.05±17.09 vs.48.74±20.18),the difference was statistically significant(P<0.05).Conclusion PEG-rhG-CSF has high efficacy and safety in preventing neutropenia after AC regimen chemotherapy for ovarian epithelial cancer,with mild adverse reactions,and can improve the quality of life of ovarian epithelial cancer patients undergoing AC regimen chemotherapy.