Prophylactic granulocyte-colony stimulating factor in patients with lung neuroendocrine carcinoma receiving platinum agents plus etoposide.
Prophylactic granulocyte-colony stimulating factor in patients with lung neuroendocrine carcinoma receiving platinum agents plus etoposide.
复制标题
接受铂类药物加依托泊苷治疗的肺神经内分泌癌患者的预防性粒细胞集落刺激因子。
DOI：
10.1016/j.ctarc.2021.100493
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Suda T.
中科院分区：
文献类型：
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作者：
Watanabe H;Karayama M;Yasui H;Inoue Y;Hozumi H;Suzuki Y;Furuhashi K;Fujisawa T;Enomoto N;Nakamura Y;Inui N;Suda T.
BackgroundThe临床效用的预防性粒细胞集落刺激因子（G-CSF）的患者接受铂剂加依托泊苷神经内分泌癌（NEC）是unknown. MethodsChemotherapy初治NEC患者接受铂剂加依托泊苷进行了回顾性评价。比较两组患者化疗后严重中性粒细胞减少和发热性中性粒细胞减少（FN）的发生率及化疗疗效（G-CSF组），未接受预防性G-CSF结果58例患者中，小细胞肺癌和大细胞NEC分别占87.9%和12.1%，顺铂和卡铂分别占24例（41.4%）和34例（58.6%）。G-CSF组和非G-CSF组分别包括32例和26例患者。非G-CSF组显示3-4级中性粒细胞减少症的发生率显著更高{88.5% [95%置信区间（CI）= 69.8% - 97.6%] vs. 56.2% [95% CI = 37.7% - 73.6%]，P= 0.009}和FN [50.9%（95% CI = 30% - 70%）vs. 18.8%（95% CI = 7.2% - 36.4%），P= 0.023]。在多因素分析中，非G-CSF是3-4级中性粒细胞减少和FN的独立危险因素。非G-CSF组治疗延迟率明显高于非G-CSF组（69.2%vs.31.2%，P = 0.001）。G-CSF组的相对剂量强度明显高于对照组（86.7%vs.74.1%，P < 0.001）。总的反应率，无进展生存期，总生存期是可比的两个groups.ConclusionsIn NEC患者接受铂剂加依托泊苷，预防性G-CSF显着降低严重的中性粒细胞减少症和FN的风险。
BackgroundThe clinical utility of prophylactic granulocyte-colony stimulating factor (G-CSF) in patients receiving platinum agents plus etoposide for neuroendocrine carcinoma (NEC) is unknown.MethodsChemotherapy-naïve patients with NEC who received platinum agents plus etoposide were retrospectively evaluated. The occurrence of severe neutropenia and febrile neutropenia (FN) and efficacy of chemotherapy were compared between patients who did (G-CSF group) and did not receive prophylactic G-CSF (non-G-CSF group).ResultsAmong 58 patients, 51 (87.9%) and 7 (12.1%) had small-cell lung cancer and large-cell NEC, respectively, and 24 (41.4%) and 34 (58.6%) received cisplatin and carboplatin, respectively. The G-CSF and non-G-CSF groups included 32 and 26 patients, respectively. The non-G-CSF group displayed significantly higher rates of grade 3–4 neutropenia {88.5% [95% confidence interval (CI) = 69.8% – 97.6%] vs. 56.2% [95% CI = 37.7% – 73.6%],P= 0.009} and FN [50.9% (95% CI = 30% – 70%) vs. 18.8% (95% CI = 7.2% – 36.4%),P= 0.023] than the G-CSF group. In multivariate analysis, non-G-CSF was an independent risk factor for grade 3–4 neutropenia and FN. The rate of treatment delay was significantly higher in the non-G-CSF group (69.2% vs. 31.2%,P= 0.001). The relative dose intensity was significantly higher in the G-CSF group (86.7% vs. 74.1%,P< 0.001). The overall response rate, progression-free survival, and overall survival were comparable between the two groups.ConclusionsIn patients with NEC receiving platinum agents plus etoposide, prophylactic G-CSF significantly reduced the risks of severe neutropenia and FN.