摘要
目的探讨预防性使用聚乙二醇重组人粒细胞刺激因子(PEG-rhG-CSF)在有营养风险的局部晚期非小细胞肺癌(NSCLC)患者化疗期间中性粒细胞缺乏中的有效性和安全性。方法选取有营养风险的局部晚期NSCLC患者337例。随机分为未预防性使用药物组112例(对照组)、预防性使用rhG-CSF治疗组112例(rhG-CSF治疗组)和预防性使用PEG-rhG-CSF治疗组113例(PEG-rhG-CSF治疗组)。观察化疗后中性粒细胞减少症的发生率和持续时间以及外周血中CD4^(+)/CD8^(+)T细胞的比值。结果对照组、rhGCSF治疗组和PEG-rhG-CSF治疗组中性粒细胞减少症发生率分别为67.97%、41.57%和37.98%(P<0.05);Ⅲ~Ⅳ度中性粒细胞减少症发生率分别为22.39%、14.25%和11.14%(P<0.05);中性粒细胞减少性发热发生率分别为3.55%、1.84%和1.21%(P<0.05);外周血中CD4^(+)/CD8^(+)T细胞比值分别为1.27±0.44、1.32±0.52和1.49±0.25(P<0.05)。PEG-rhG-CSF治疗组Ⅲ~Ⅳ度中性粒细胞减少症持续时间和中性粒细胞值从最低值到2.0×10^(9)/L以上所需时间均低于对照组和rhG-CSF治疗组(P<0.05)。结论预防性使用PEG-rhG-CSF能降低有营养风险的局部晚期NSCLC化疗期间中性粒细胞减少症的发生率,增强患者免疫功能。
Objective To explore the efficacy and safety of polyethylene glycol recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF)in preventing chemotherapy-induced neutropenia in locally advanced non small cell lung cancer(NSCLC)patients at nutritional risk.Methods A total of 337 locally advanced NSCLC patients at nutritional risk were selected.They were randomly divided into three groups:112 cases in the non-prophylactic drug group(control group),112 cases in the prophylactic use of rhG-CSF treatment group(rhG-CSF group),and 113 cases in the prophylactic use of PEG-rhG-CSF treatment group(PEG-rhG-CSF group).The incidence and duration of neutropenia after chemotherapy and the ratio of CD4^(+)/CD8^(+)T cells in peripheral blood were observed.Results The incidences of neutropenia in the control group,rhG-CSF group,and PEG-rhG-CSF group were 67.97%,41.57%,and 38.98%(P<0.05),respectively.The incidences of grade Ⅲ-Ⅳ neutropenia in the three groups were 22.39%,14.25%,and 11.14%(P<0.05);moreover,the incidence of febrile neutropenia in the three groups was 3.55%,1.84%,and 1.21%(P<0.05);in addition,the ratios of CD4^(+)/CD8^(+)T cells in peripheral blood were 1.27±0.44,1.41±0.52,and 1.49±0.42(P<0.05).The duration of grade Ⅲ-Ⅳ neutropenia and the time required for the neutrophil value to reach 2.0×10^(9)/L from the lowest value in the PEG-rhG-CSF group were lower than those in the control and rhG-CSF groups(P<0.05).Conclusion The PEG-rhG-CSF preventive treatment used in the course of chemoradiotherapy in locally advanced NSCLC patients at nutritional risk can reduce the incidence of neutropenia and improve immunologic function.PEG-rhG-CSF preventive treatment is worthy of clinical recommendation.
作者
田震
朱能
李子林
陈永忠
李宏
张新华
TIAN Zhen;ZHU Neng;LI Zilin;CHEN Yongzhong;LI Hong;ZHANG Xinhua(Department of Minimally Invasive Interventional Radiology,Hubei Cancer Hospital,Wuhan 430079,China)
出处
《肿瘤防治研究》
CAS
CSCD
2022年第9期904-907,共4页
Cancer Research on Prevention and Treatment
基金
希思科-石药肿瘤研究基金资助(Y-sy2018-053)。
