癌症化疗后预防性应用粒细胞集落刺激因子的适应症探讨  

A clinical study on the indications of prophylactic application of G-CSF in chemotherapy patients

作　　者：谢德荣[1] 陈岱佳[1] 梁新文[1] 姚和瑞[1] 林显敢[1] 张惠宜[1] 

机构地区：[1]中山医科大学孙逸仙纪念医院肿瘤科,广州510120

出　　处：《中国肿瘤临床与康复》2001年第5期36-37,共2页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的　探讨癌症患者化疗后预防性应用粒细胞集落刺激因子 (G CSF)的适应症。方法　入选病例具备下列条件之一 :既往类似化疗后出现Ⅲ～Ⅳ度血液学毒性、感染、或Ⅱ度以上口腔炎 ,或增加化疗剂量强度 ,平均相对剂量强度≥ 1.2。共 35例患者入选 ,均完成 2个周期化疗。采用自身交叉对照的方法 ,比较化疗后预防性 (预防组 )及治疗性(对照组 )应用G CSF的疗效及治疗费用。结果　预防组白细胞、中性粒细胞Ⅲ～Ⅳ度、化疗后 2 1天白细胞Ⅰ度以上毒性、感染分别为 2、2、3、和 1例 ,均明显低于对照组的 11(P =0 .0 0 5 7)、12 (P =0 .0 0 2 8)、18(P =0 .0 0 0 1)和 8例 (P =0 .0 2 75 ) ;G CSF费用两组相似 ( 2 12 3元vs 1743元 ,P =0 .2 44 ) ,而抗生素费用 ( 5 0 9元vs 12 88元 ,P =0 .0 0 4)、延期出院费用( 5 1vs 2 15元 ,P =0 .0 0 1)、其它相关费用 ( 2 65元vs 10 2 6元 ,P =0 .0 0 7)及总费用 ( 2 948元vs 42 72元 ,P =0 .0 0 9)预防组明显低于对照组。结论　既往类似化疗后出现Ⅲ～Ⅳ度血液学毒性、感染、Ⅱ度以上口腔炎或增加化疗剂量强度 ,平均相对剂量强度≥ 1.2者 ,预防性应用G CSF ,有助于减轻化疗的血液学毒性、降低治疗费用。Objective To study the indications of prophylactic application of G-CSF in patients received chemotherapy.Methods Thirty-five patients who had 3/4 degree toxicity of hematology,infection,or 2 to 4 degree of stomatitis caused by analogous chemotherapy in the past,or received chemotherapy of average relative dose intensity of more than 1.2 were studied using cross-over trial.All patients received 2 cycles of chemotherapy and then divided into prophylactic (prophylactic group)and therapeutic (control group),both groups beiny treated with G-CSF.The efficacy and therapy cost were compared in two groups.Results The 3/4 degree toxicity of leucocyte and neutrophil,1 to 4 degree toxicity of leucocyte 21 days after chemotherapy and infection were 2,2,3 and 1 case in prophylactic group,11(P=0.0057),12(P=0.0028),18 (P=0.001) and 8 (P=0.0275) in control group,respectively.The cost of G-CSF was almost the same in the two groups,but other related cost in prophybctic group was lower than that in control group.Conclusion The patients who have the above mentioned symtoms may be the indications of prophylactic application of G-CSF after chemotherapy.It might be good for reducing toxicity of hematology and therapy cost.

关 键 词：化学治疗 粒细胞集落刺激因子 预防性用药 适应症 

分 类 号：R730.5[医药卫生—肿瘤]