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首页> 外文期刊>Clinical colorectal cancer >A randomized, placebo-controlled phase ii study evaluating the reduction of neutropenia and febrile neutropenia in patients with colorectal cancer receiving pegfilgrastim with every-2-week chemotherapy.
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A randomized, placebo-controlled phase ii study evaluating the reduction of neutropenia and febrile neutropenia in patients with colorectal cancer receiving pegfilgrastim with every-2-week chemotherapy.

机译:一项随机,安慰剂对照的ii期研究,评估每2周接受一次化疗的接受培格非司汀治疗的大肠癌患者中性粒细胞减少和发热性中性粒细胞减少的情况。

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BACKGROUND: Adding irinotecan and/or oxaliplatin to every-2-week 5-fluorouracil (5-FU)/leucovorin (LV) prolongs survival in patients with colorectal cancer (CRC) but increases neutropenia frequency. Pegfilgrastim is indicated to decrease infection as manifested by febrile neutropenia (FN) in patients receiving chemotherapy at > 14-day intervals. This randomized, placebo-controlled phase II study examined pegfilgrastim efficacy and safety in patients with CRC receiving every-2-week chemotherapy. PATIENTS AND METHODS: Patients with CRC were randomized 1:1 to pegfilgrastim 6 mg or placebo administered per-cycle on day 4. Randomization was stratified by chemotherapy regimen (patients received every-2-week FOLFOX4 [5-FU/LV/oxaliplatin], FOLFIRI [5-FU/LV/irinotecan], or FOIL [5-FU/LV/oxaliplatin/irinotecan] at physician discretion). The primary endpoint was incidence of grade 3/4 neutropenia. Secondary endpoints included incidence of grade 3/4 FN and adverse events. After 4 cycles of study treatment, progression-free survival (PFS) and overall survival (OS) were followed for
机译:背景:每2周向5氟尿嘧啶(5-FU)/亚叶酸(LV)添加伊立替康和/或奥沙利铂可延长结直肠癌(CRC)患者的生存期,但会增加中性粒细胞减少症的发生频率。 Pegfilgrastim被表明可减少以大于14天的间隔接受化疗的患者的发热性中性粒细胞减少症(FN)表现出的感染。这项随机,安慰剂对照的II期研究检查了每2周接受化疗的pegfilgrastim对CRC患者的疗效和安全性。患者与方法:CRC患者在第4天每周期1:1随机分配给培非非司亭6 mg或安慰剂,按化疗方案分层(患者每2周接受FOLFOX4 [5-FU / LV / oxaliplatin]治疗,FOLFIRI [5-FU / LV /伊立替康]或FOIL [5-FU / LV /奥沙利铂/伊立替康](由医生自行决定)。主要终点为3/4级中性粒细胞减少症的发生率。次要终点包括3/4级FN发生率和不良事件。在4个周期的研究治疗后,对长期随访的无进展生存期(PFS)和总体生存期(OS)进行了≤2年的随访。结果:在分析的241例合格患者中,安慰剂组118例,培格非司亭组123例。在治疗期间,pegfilgrastim与安慰剂的3/4级中性粒细胞减少症的优势比为0.19(95%CI,0.10-0.37; P <.001);与接受安慰剂治疗的患者(8%; P = .04)相比,接受pegfilgrastim治疗的患者(2%)的3/4级FN发生率也显着降低。 Pegfilgrastim的耐受性良好,在第2-4个周期中白细胞计数保持稳定。在长期随访中,两个治疗组的PFS和OS均相似。结论:每2周接受一次化疗的CRC患者对Pegfilgrastim的耐受性良好,与安慰剂相比,中性粒细胞减少和FN明显降低,尽管FN在两种治疗组中均不常见。结果表明,pegfilgrastim给药在每2周接受化疗的CRC患者中是可行的。

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