Clinical analysis of the use of PEG-rhG-CSF after chemotherapy in patients with soft tissue sarcoma / 肿瘤

ABSTRACT

Objective: To analyze the clinical effect of prophylactic use of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) after chemotherapy in patients with soft tissue sarcoma. Methods: The clinical data of the patients with soft tissue sarcoma who were diagnosed in the Oncology Department of Zhongshan Hospital Affiliated to Fudan Universtiy from July 2016 to July 2019, and received the preventive treatment of PEG-rhG-CSF after chemotherapy to prevent the increase of leukocyte count in vivo, was collected and analyzed. Results: A total of 107 patients with soft tissue sarcoma were treated with PEG-rhG-CSF after chemotherapy. The incidence of neutropenia was 48.6% (52/107), in which the incidence of grade 3-4 neutropenia was 28.0% (30/107), and the incidence of febrile neutropenia (FN) was 4.7% (5/107). The incidence of neutropenia in male or female patients was 52.8% (28/53) or 44.4% (24/54), respectively; there was no significant difference (P > 0.05). The incidence of neutropenia in elderly patients (≥ 65 years old) or young and mid-aged patients ( 0.05). The use of IA chemotherapy with ifosfamide and doxorubicin was more toxic, the incidence of neutropenia was 50.9% (27/53) with 4 cases of FN. In the patients who received major surgery (grade 3-4) or those who did not receive major surgery (grade 1-2 and no surgery), the incidence of neutropenia was 60.0% (36/60) or 34.0% (16/47), respectively; there was significant difference (P < 0.05). In the patients who received radiotherapy or those without radiotherapy, the incidence of neutropenia was 70.0% (14/20) or 43.7% (38/87), respectively; there was significant difference (P < 0.05). Conclusion: The prophylactic use of PEG-rhG-CSF can avoid severe myelotoxicity in the majority of patients with soft tissue sarcoma. However, the risk of neutropenia is still high in the patients who received chemotherapy based on ifosfamide and anthracyclines, as well as in the patients who have received radiotherapy and major surgery in the past. All these are worthy of concern.