硫培非格司亭预防乳腺癌患者化疗相关中性粒细胞减少的疗效  

Efficacy of mecapegfilgrastim for prophylaxis of chemotherapy-induced neutropenia in patients with breast cancer

作　　者：刘嘉琦 初军 张超[1] 于河山 崔海云 魏菲菲 丁宇[1] LIU Jiaqi;CHU Jun;ZHANG Chao;YU Heshan;CUI Haiyun;WEI Feifei;DING Yu(Department of Breast and Thyroid Surgery,Zibo City Central Hospital,Zibo Shandong 255000;Department of Obstetrics and Gynecology,Zhoucun People’s Hospital,Zibo Shandong 255300;Department of Obstetrics and Gynecology,Weifang Maternal and Child Health Hospital,Weifang Shandong 261000,China)

机构地区：[1]淄博市中心医院乳腺甲状腺外科,山东淄博255000 [2]周村区人民医院妇产科,山东淄博255300 [3]潍坊市妇幼保健院妇产科,山东潍坊261000

出　　处：《临床与病理杂志》2022年第10期2434-2439,共6页Journal of Clinical and Pathological Research

摘　　要：目的:研究硫培非格司亭预防乳腺癌患者术后辅助化疗相关中性粒细胞减少的疗效及安全性。方法:回顾性分析2020年4月1日至2021年2月20日于淄博市中心医院乳腺甲状腺外科178例术后行表柔比星联合环磷酰胺辅助化疗的乳腺癌患者。患者首次化疗及后续化疗48 h后皮下注射硫培非格司亭6 mg。动态监测血常规。统计每次化疗后中性粒细胞减少的发生率、Ⅳ度中性粒细胞减少的发生率、每次化疗结束后中性粒细胞出现最低值的时间、中性粒细胞应用重组人粒细胞集落刺激因子(pegylated recombinant human granulocyte colony-stimulating factor,G-CSF)恢复至>2×109/L的时间,以及不良反应发生情况。结果:178例乳腺癌患者中3例患者仅完成3周期化疗,其余均完成4个化疗周期,所有患者在化疗后均预防性使用硫培非格司亭。所有化疗周期结束后,中性粒细胞减少至最低点的时间为(10.15±1.21) d,中性粒细胞减少发生率为6.77%,Ⅳ度中性粒细胞减少的发生率为2.12%,中性粒细胞应用G-CSF恢复至>2×109/L的时间(1.85±1.34)d;第1~4个化疗周期,分别有45、43、47、46例患者发生骨痛和肌痛,分别有15、10、11、7例患者发生发热,给予对症治疗后均缓解。结论:乳腺癌患者化疗后预防性使用硫培非格司亭,可以明显降低中性粒细胞减少及FN的发生率,提高了化疗的安全性,值得临床推广。Objective:To investigate the efficacy and safety of mecapegfilgrastim for chemotherapy-induced neutropenia in patients with breast cancer who received postoperative adjuvant chemotherapy.Methods:This was a retrospective study.A total of 178 eligible patients with breast cancer received postoperative epirubicin combined with cyclophosphamide adjuvant chemotherapy in the Breast and Thyroid Surgery Department of Zibo Central Hospital from April 1, 2020 to February 20, 2021. The patients received subcutaneous injection of 6 mg of mecapegfilgrastim 48 h after the first chemotherapy and subsequent chemotherapy. Blood routine was dynamically monitored. The incidence of neutropenia after each chemotherapy, the incidence of grade Ⅳ neutropenia, the time to the lowest value of neutrophils after each chemotherapy, the time for neutrophils to apply pegylated recombinant human granulocyte colony-stimulating factor (G-CSF) to recover to >2×109/L, and the occurrence of adverse reactions (such as bone pain, myalgia and fever) were counted. Results: Of the 178 patients with breast cancer, 3 patients completed only 3 cycles of chemotherapy, and the rest completed 4 cycles of chemotherapy, and all patients received prophylactic use of mecapegfilgrastimin after chemotherapy. After all chemotherapy cycles, the time for neutropenia to reach the nadir was (10.15±1.21) d. The incidence was 6.77% of neutropenia and 2.12% of grade Ⅳ neutropenia. The time for neutrophils to apply G-CSF to recover to >2×109/L was (1.85±1.34) d. From the first to the fourth chemotherapy cycle, 45, 43, 47, 46 patients developed bone pain and myalgia;15, 10, 11, and 7 patients developed fever, respectively, who were relieved after symptomatic treatment. Conclusion: Prophylactic use of mecapegfilgrastim after chemotherapy in patients with breast cancer can significantly reduce the incidence of neutropenia and FN, improve the safety of chemotherapy, and is worthy of clinical promotion.

关 键 词：乳腺癌化疗 中性粒细胞减少 硫培非格司亭 并发症 

分 类 号：R737.9[医药卫生—肿瘤]