PEG-rhG-CSF预防结肠癌双周剂量密集方案辅助化疗后中性粒细胞减少的临床疗效观察

摘要

目的:观察聚乙二醇化重组人粒细胞集落刺激因子 (polyethylene glycol recombinant human granulocyte colony stimulating factor, PEG-rh G-CSF) 预防结肠癌双周剂量密集方案 (FOLFOX6) 辅助化疗后中性粒细胞减少的疗效和安全性.方法:收集中国人民解放军北部战区总医院2016年12月至2017年9月间52例接受剂量密集方案辅助化疗的结肠癌患者, 治疗组20例化疗后24小时皮下注射6 mg PEG-rh G-CSF, 对照组32例化疗后未使PEG-rh G-CSF, 患者出院后根据验血结果由经治医师决定是否加用重组人粒细胞集落刺激因子 (rh G-CSF) .主要观察患者再次应用rh G-CSF的频次、患者Ⅲ-Ⅳ度中性粒细胞减少的发生率、患者粒缺性发热的发生率、因粒细胞减少而进行减量或延迟治疗的发生率以及患者生活质量改善情况 (C-30量表) .结果:治疗组患者无需再次注射rh G-CSF, 而对照组患者26例需加用rh G-CSF, 并且对照组8例发生Ⅲ-Ⅳ度中性粒细胞减少、2例发生粒缺性发热、4例和7例分别因粒细胞减少而减量和延迟治疗.治疗组患者生理状况、社会/家庭状况和总评分显著高于对照组患者.两组患者不良反应发生率相当, 无统计学差异.结论:应用PEG-rh G-CSF可有效预防结肠癌剂量密集方案辅助化疗后Ⅲ-Ⅳ度中性粒细胞减少的发生, 减少因上述不良反应而延迟化疗的发生, 化疗间歇期患者无需再次应用rh G-CSF治疗, 同时提高患者生活质量.PEG-rhG-CSF安全性高, 无明显不良反应.%Objective: To observe the efficacy and safety of polyethylene glycol recombinant human granulocyte colony stimulating factor (PEG-rh G-CSF) in preventing neutropenia after adjuvant chemotherapy in colon cancer.Methods: In the General Hospital of the Northern Theater of the Chinese People's Liberation Army from December2016 to September 2017, 52 patients received a dose-dense regimen adjuvant chemotherapy for colon cancer patients. 20 patients in the treatment group were subcutaneously injected with 6 mg PEG-rh G-CSF 24 hours after chemotherapy. The control group (32 cases) was not treated with PEG-rh G-CSF after chemotherapy. After discharge, according to the blood test results, the doctor decided whether to add recombinant human granulocyte colony stimulating factor (rh G-CSF) . We mainly observed the frequency of rh G-CSF application again, the incidence ofⅢ-Ⅳ degree neutropenia, the incidence of granulocytic fever, the incidence of reduction or delayed treatment and the quality of life (C-30 scale) due to granulocytopenia. Results: The patients in the treatment group did not need to be injected with rh G-CSF again, while 26 patients in the control group needed rh G-CSF, and 8 patients in the control group had Ⅲ-Ⅳ degree neutropenia and 2 patients had fever due to granulocytopenia, 4 and 7 patients had decrement and delayed treatment because of granulocytopenia. The physiological status, social/family status and total score of the patients in the treatment group were significantly higher than those in the control group. The incidence of adverse reactions was similar between the two groups, and there was no statistical difference between the two groups.Conclusion: PEG-rh G-CSF can prevent the occurrence of Ⅲ-Ⅳ degree neutropenia after neoadjuvant chemotherapy, reduce delayed chemotherapy due to the occurrence of adverse reactions, without application of rh G-CSF treatment in patients with intermittent chemotherapy, and improve the safety and quality of life in patients. PEG-rh G-CSF has high safety and no obvious adverse reaction.