摘要
目的研究聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)防治老年肺鳞癌患者化疗相关粒细胞减少的疗效。方法本研究为自身对照研究,选取23例化疗后出现2级以上中性粒细胞绝对值(ANC)减少的老年男性肺鳞癌患者作为研究对象,在试验周期化疗后48 h预防性应用PEG-rhG-CSF(100μg/kg),密切观察两组化疗后ANC动态变化,若出现ANC减少,均予rhG-CSF(5μg/kg,每天1次)升白处理至ANC大于10.0×10^9/L停药,比较疗效与安全性指标。结果试验组预防性使用PEG-rhG-CSF后,化疗第6、8、20天ANC显著高于对照组,且ANC极小值显著高于对照组,rhG-CSF使用时间显著缩短。对照组出现3/4级ANC减少9例(39.1%),乏力16例(69.6%),FN5例(21.7%),继发感染4例(17.4%),化疗延迟12例(52.2%),均显著高于试验组。两组骨髓生长因子(MGF)的主要不良反应为骨痛,发生率差异无统计学意义。结论预防性使用PEG-rhG-CSF,能够有效降低老年肺鳞癌患者化疗相关重度ANC减少和FN的发生率,保证化疗按时进行;同时显著缩短rhG-CSF使用天数,提高患者的依从性和生活质量。
Objective To investigate the efficacy of pegylated recombinant human granulocyte-colonystimulating factor(PEG-rhG-CSF)as prophylaxis for chemotherapy-induced neutropenia in elderly patients with lung squamous carcinoma.Methods In this self-control study,23 elderly patients with lung squamous carcinoma were selected as control group because of chemotherapy-induced neutropenia above grade 2 in the control-chemotherapy-cycle.In the next study-chemotherapy-cycle,all the patients received a single subcutaneous injection of PEG-rhG-CSF(100μg/kg).The absolute neutrophil count(ANC)of patients in both groups were recorded every other day since the 4th chemotherapy day,and patients with neutropenia received daily subcutaneous injections of rhG-CSF(5μg/kg)until the ANC was above 10.0×109/L.We analyze the efficacy and safety parameters.Results In the study group,the mean ANC value of the 6th,8th,20th chemotherapy day was significantly higher than that in the control group respectively,the minimal ANC value was higher,and the duration of rhG-CSF was shortter.In the control group,the incidence of grade 3/4 neutropenia(39.1%),fatigue(69.6%),febrile neutropenia(21.7%),infection(17.4%)and chemotherapy-delay rate(52.2%)was significantly higher than that in the study group,respectively.The most common adverse reaction of myeloid growth factors is bone pain,but there is no statistical difference in the incidence between the two groups.Conclusion Prophylactic use of PEGrhG-CSF can significantly reduce the incidence of chemotherapy-induced grade 3/4 neutropenia and FN in elderly patients with lung squamous carcinoma,and improve their compliance and quality of life by decreasing the the duration of rhG-CSF.
作者
喻存俊
高健
YU Cun-jun;GAO Jian(Department of Respiratory Medicine,Nanjing Chest Hospital,Nanjing 210029,China)
出处
《中国处方药》
2020年第12期138-140,共3页
Journal of China Prescription Drug
关键词
聚乙二醇化重组人粒细胞集落刺激因子
老年
肺鳞癌
化疗
中性粒细胞减少
Pegylated recombinant human granulocyte colony-stimulating factor
Elderly
Lung squamous carcinoma
Chemotherapy
Neutropenia
