Clinical observation of prophylactic use of pegylated recombinant human granulocyte stimulating factor in breast cancer patients with postoperative radiotherapy

Abstract

Abstract:

ObjectiveTo investigate the efficacy and adverse effects of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing neutropenia in patients undergoing sequential adjuvant radiotherapy after postoperative chemotherapy for breast cancer.MethodsA total of 43 female patients with breast cancer from January 2017 to January 2019 in Shandong Cancer Hospital and Institute were analyzed prospectively. Twenty-one patients in the experimental group were given 6 mg of PEG-rhG-CSF subcutaneously 1-3 days before radiotherapy. In the control group, 22 patients were enrolled without PEG-rhG-CSF utilization. The lowest absolute neutrophil count (ANC), the number of days of radiotherapy interruption due to neutropenia, the number of recombinant human granulocyte colony-stimulating factor (rhG-CSF) used during radiotherapy and the occurrence of drug-induced skeletal muscle pain in the two groups were statistically analyzed.ResultsNo neutropenia fever was observed in the two groups during radiotherapy. In the experimental group, there was no case of grade Ⅲ neutropenia; while in the control group, there were 3 cases of grade Ⅲ neutropenia. The median value of the lowest ANC in the experimental group was 1.56×10⁹/L, higher than that in the control group (1.37×10⁹/L), with a statistically significant difference (Z=-2.261,P=0.023). The median number of rhG-CSF used in the experimental group was 1, which was smaller than 2 in the control group, and the difference was statistically significant (Z=-2.498,P=0.012). The median numbers of days of radiotherapy interruption due to neutropenia were 0 and 3 in the experimental group and the control group, with a statistically significant difference (Z=-3.117,P=0.001). One case (4.8%) of drug-induced skeletal muscle pain was found in the experimental group and 5 cases (22.7%) in the control group, with no statistically significant difference (χ²=1.586,P=0.208).ConclusionPEG-rhG-CSF can effectively prevent neutropenia caused by radiotherapy after postoperative chemotherapy for patients with breast cancer, and can reduce the interruption of radiotherapy and the use of rhG-CSF during radiotherapy, which is helpful to the smooth process of radiotherapy.

Key words:Breast neoplasms,Radiotherapy,Neutropenia,Granulocyte colony-stimulating factor,Pegylation

Du Yanfang, Fan Yanling, Hu Bing, Sun Lei, Liu Yuanjian, Li Baosheng, Huang Wei. Clinical observation of prophylactic use of pegylated recombinant human granulocyte stimulating factor in breast cancer patients with postoperative radiotherapy[J]. Journal of International Oncology, 2020, 47(3): 141-145.

Figures/Tables2

临床特征	观察组 (n=21)	对照组 (n=22)	χ²值	P值
年龄(岁)
<50	11	11	0.024	0.876
≥50	10	11
KPS评分
80~90	12	11	0.220	0.639
>90	9	11
术后分期
Ⅱ期	7	6	0.187	0.665
Ⅲ期	14	16
初始ANC
<3×10⁹/L	12	12	0.029	0.864
≥3×10⁹/L	9	10

指标	观察组 (n=21)	对照组 (n=22)	Z值	P值
ANC最低值(×10⁹/L)	1.56(1.19~4.03)	1.37(0.82~3.06)	-2.261	0.023
rhG-CSF使用支数(支)	1(0~3)	2(0~14)	-2.498	0.012
放疗中断天数(d)	0(0~2)	3(0~4)	-3.117	0.001

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