| 董昕,余荣,邓玮,赵雨婷,姜蕾蕾,杨丹,于会明,石安辉,王维虎.预防性使用聚乙二醇化重组人粒细胞集落刺激因子在肺癌患者同步放化疗中的作用[J].中华放射医学与防护杂志,2022,42(11):881-887 |
| 预防性使用聚乙二醇化重组人粒细胞集落刺激因子在肺癌患者同步放化疗中的作用 |
| Effect of preventive application of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) during concurrent chemoradiotherapy in patients with lung cancer |
| 投稿时间：2022-09-30 |
| DOI：10.3760/cma.j.cn112271-20220930-00397 |
| 中文关键词: 肺癌 同步放化疗 PEG-rhG-CSF 中性粒细胞减少症 |
| 英文关键词:Lung cancer concurrent chemoradiotherapy PEG-rhG-CSF neutropenia. |
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| 中文摘要: |
| 目的 评价预防性使用聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)在肺癌同步放化疗期间预防中性粒细胞减少症的作用。方法 回顾性分析2020年4月至2021年4月于北京大学肿瘤医院接受同步放化疗的149例肺癌患者的临床资料,其中预防组79例,包括初级预防组(全程同步放化疗中预防使用PEG-rhG-CSF)48例,次级预防组(出现粒细胞减少后的化疗周期中预防使用PEG-rhG-CSF)31例;未预防组70例。对比预防组和未预防组之间3~4级中性粒细胞减少症的发生率、同步放化疗完成率、放化疗剂量减量和治疗时间延迟发生率。结果 全组患者在放化疗中出现3~4级中性粒细胞减少症的发生率为32.2%(48/149)。其中,初级预防组的发生率为6.3%(3/48),次级预防组的发生率为9.7%(3/31),未预防组的发生率为35.7%(25/70)。预防组(初级预防+次级预防)与未预防组中性粒细胞减少症的发生率差异有统计学意义(χ2=17.81,P＜0.001)。全组粒细胞缺乏伴发热的发生率为3.4%(5/149),未在初级预防组出现。同步放化疗足量完成率在预防组为96.2%(76/79),明显高于未预防组的82.9%(58/70),差异有统计学意义(χ2=7.30,P=0.007)。预防组放化疗剂量减量和治疗时间延迟发生率为19.0%(15/79),未预防组为40.0%(28/70),差异有统计学意义(χ2=7.98,P=0.005)。结论 PEG-rhG-CSF的预防使用可以有效降低3~4级中性粒细胞减少症的发生,更好地保证肺癌患者同步放化疗按计划完成。 |
| 英文摘要: |
| Objective To evaluate the effect of preventive application of PEG-rhG-CSF on the prevention of neutropenia during concurrent chemoradiotherapy in patients with lung cancer.Methods A total of 149 patients with lung cancer who received concurrent chemoradiotherapy at Peking University Cancer Hospital from April 2020 to April 2021 were retrospectively analyzed. There were 79 cases in the prevention group, including 48 cases of primary prevention group (preventive application of PEG-rhG-CSF in all concurrent chemoradiotherapy cycles) and 31 cases of secondary prevention group (preventive application of PEG-rhG-CSF in the concurrent chemoradiotherapy cycles after neutropenia occurred). There were 70 cases in non-prevention group. The incidence of grade 3-4 neutropenia, the completion rate of concurrent chemoradiotherapy, the rate of chemoradiotherapy dose reduction and treatment delay, and the rate of hematological toxicities related hospitalization were compared between the prevention group and the non-prevention group.Results The incidence of grade 3-4 neutropenia in the whole group was 32.2% (48/149), including 6.3% (3/48) in the primary prevention group, 9.7% (3/31) in the secondary prevention group, and 35.7% (25/70) in the non-prevention group. The difference was statistically significant (χ2=17.81, P＜0.001) in the incidence of grade 3-4 neutropenia. The incidence of febrile neutropenia was 3.4% (5/149) in the whole group, but none of them occurred in the primary prevention group. The full completion rate of concurrent chemotherapy was 96.2% (76/79) in the prevention group, which was significantly higher than 82.9% (58/70) in the non-prevention group (χ2=7.30, P=0.007). The incidence of treatment delayed and dose reduction of chemoradiotherapy was 19.0% (15/79) in the prevention group and 40.0% (28/70) in the non-prevention group, and the difference was statistically significant (χ2=7.98, P=0.005).Conclusions The preventive application of PEG-rhG-CSF can effectively reduce the incidence of neutropenia and better ensure the concurrent chemoradiotherapy in lung cancer patients on schedule. |
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