预防性应用长效粒细胞集落刺激因子在乳腺癌辅助化疗中的作用  

The role of prophylactic use of pegylated recombinant human granulocyte colony-stimulating factor （PEG-rhG-CSF） in breast cancer receiving adjuvant chemotherapy

作　　者：张嘉扬[1] 刘雅昕[1] 王环[1] 米岚[2] 宋国红[1] 姜晗昉 严颖[1] 邵彬[1] 孔维垚 张如艳[1] 冉然[1] 刘笑然[1] 王晶[1] 林艳棠 李惠平[1] Zhang Jiayang;Liu Yaxin;Wang Huan;Mi Lan;Song Guohong;Jiang Hanfang;Yah Ying;Shao Bin;Kong Weiyao;Zhang Ruyan;Ran Ran;Liu Xiaoran;Wang Jng;Lin Yantang;Li Huiping(Key Laboratory of Carcinogenesis and Translational Research（Ministry of Education）,Department of Breast Oncology,Peking University Cancer Hospital ＆ Institute,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所乳腺肿瘤内科,恶性肿瘤发病机制及转化研究教育部重点实验室,100142 [2]北京大学肿瘤医院暨北京市肿瘤防治研究所 恶性肿瘤发病机制及转化研究教育部重点实验室

出　　处：《中华医学杂志》2018年第34期2718-2721,共4页National Medical Journal of China

摘　　要：目的 探讨预防性应用聚乙二醇化重组人粒细胞集落刺激因子（PEG-rhG-CSF）在多西他赛方案辅助化疗乳腺癌患者中预防中性粒细胞减少的疗效和安全性.方法 选择2014年1月—2017年10月接受多西他赛方案辅助化疗的乳腺癌患者58例,预防性应用PEG-rhG-CSF.在总共4周期的辅助化疗中,根据单个周期患者是否应用PEG-rhG-CSF分为长效升白针预防组及长效升白针非预防组.进一步根据单个患者接受PEG-rhG-CSF治疗周期数分为频繁应用组（应用PEG-rhG-CSF≥3周期）和非频繁应用组（应用PEG-rhG-CSF〈3周期）.结果 在第1～3周期化疗,预防升白组与非预防组比较,患者3～4度中性粒细胞降低发生率较低,且差异均有统计学意义（均P〈0.05）.在第1和第3周期化疗,预防升白组与非预防组相比较,患者3～4度中性粒细胞减少伴发热发生率较低,差异有统计学意义（P〈0.05）.频繁应用长效组与非频繁组相比,3～4度中性粒细胞减少及粒细胞减少性发热的发生率较低（P〈0.001）.PEG-rhG-CSF预防用药组2例（3.4％）患者因不能耐受严重骨痛停止治疗.结论 PEG-rhG-CSF可有效预防接受多西他赛方案辅助化疗的乳腺癌患者中性粒细胞减少及发热的发生概率率,值得在临床上进行推广和应用.Objectives To investigate the efficacy and safety of prophylactic use of pegylated recombinant human granulocyte colony -stimulating factor （ PEG-rhG-CSF ） in breast cancer receiving docetaxel as adjuvant chemotherapy .Methods A total of 58 patients with breast cancer receiving adjuvant chemotherapy with docetaxel were included between January 2014 to October 2017.Prophylactic use of PEG-rhG-CSF was administered.Patients were further divided into two groups according to the frequency of PEG -rhG-CSF use： frequent use group （≥3 cycles） and non-frequent use group （ 〈3 cycles）.Results There were significant differences in the incidence rates of grade 3 /4 neutropenia between the prophylactic group and non-prophylactic group in cycle 1 -3（P 〈0.05）.Less febrile neutropenia （FN） was also noted in the prophylactic group compared with the non -prophylactic group in cycle 1 and cycle 3 （P 〈0.05）.Grade 3/4 neutropenia and FN were less in the frequent use of group compared with the non -frequent use group （P 〈0.001） .The most common side effects of PEG-rhG-CSF included fatigue （10.2%）, bone joint pain （50.8%）,and 2 patients （3.4%） refused further treatment because of bone joint pain .ConclusionsPEG-rhG-CSF should be prophylactically used for preventing neutropenia and febrile neutropenia in breast cancer patients receiving adjuvant chemotherapy with docetaxel regimen .

关 键 词：乳腺肿瘤 辅助化疗 聚乙二醇化重组人粒细胞集落刺激因子 中性粒细胞减少 

分 类 号：R737.9[医药卫生—肿瘤]