Efficacy and safety of PEG-rhG-CSF in preventing chemoradiotherapy-induced neutropenia in patients with locally advanced cervical cancer

Authors

  • Weiwei Li Department of Radiation Oncology, The First Affiliated Hospital, Air Force Medical University, Xi an, China https://orcid.org/0000-0002-5249-0457
  • Mohan Dong Department of Medical Education, The First Affiliated Hospital, Air Force Medical University, Xi an, China
  • Shigao Huang Department of Radiation Oncology, The First Affiliated Hospital, Air Force Medical University, Xi an, China https://orcid.org/0000-0001-7365-4441
  • Liu Shi Department of Radiation Oncology, The First Affiliated Hospital, Air Force Medical University, Xi an, China
  • Hua Yang Department of Radiation Oncology, The First Affiliated Hospital, Air Force Medical University, Xi an, China
  • Ying Zhang Department of Radiation Oncology, The First Affiliated Hospital, Air Force Medical University, Xi an, China
  • Jie Gong Department of Radiation Oncology, The First Affiliated Hospital, Air Force Medical University, Xi an, China
  • Mei Shi Department of Radiation Oncology, The First Affiliated Hospital, Air Force Medical University, Xi an, China
  • Lichun Wei Department of Radiation Oncology, The First Affiliated Hospital, Air Force Medical University, Xi an, China
  • Lina Zhao Department of Radiation Oncology, The First Affiliated Hospital, Air Force Medical University, Xi an, China

DOI:

https://doi.org/10.17305/bjbms.2022.7859

Keywords:

Cervical cancer, PEG-rhG-CSF, concurrent chemoradiotherapy, radical chemoradiotherapy, neutropenia

Abstract

The standard of care for locally advanced cervical cancer is concurrent chemoradiotherapy, which is associated with significant toxicity, especially hematologic toxicity. To evaluate the efficacy and safety of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing neutropenia during radical chemoradiotherapy for cervical cancer, 40 patients receiving prophylaxis from February 2018 to July 2019 were randomly divided into two arms in a 1:1 ratio. Patients in the study arm (N = 21) received PEG-rhG-CSF, while patients in the control arm (N = 19) received short-acting rhG-CSF. The primary endpoint was the incidence of grade 3–4 neutropenia, and the secondary endpoints were the incidence of febrile neutropenia, chemotherapy delay, and radiotherapy interruption. In addition, dynamic changes in absolute neutrophil count during radical chemoradiotherapy and adverse events were compared between the two groups. There were 0 and 4 cycles of grade 3–4 neutropenia in the PEG-rhG-CSF and rhG-CSF groups, respectively. The incidence of neutropenia of all grades was lower in patients on PEG-rhG-CSF than on rhG-CSF [24.05% (19/79) vs. 56.94% (41/72); p < 0.001]. No patient developed neutropenic fever. The lowest values of neutropenia during concurrent chemoradiotherapy cycles were 2.73 ± 1.02 and 1.91 ± 0.79 × 10 9/ml in the PEG-rhG-CSF and rhG-CSF groups, respectively (p < 0.001). In the PEG-rhG-CSF and rhG-CSF groups, 0 and 8 (11.11%) cycles of chemotherapy were delayed due to neutropenia, respectively (p = 0.01). There was no delay of radiotherapy by more than one week in either group. Prophylactic use of PEG-rhG-CSF during chemoradiotherapy for cervical cancer can effectively prevent neutropenia and associated adverse events. PEG-rhG-CSF may be an effective strategy to provide uninterrupted radical chemoradiotherapy for cervical cancer.

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Efficacy and safety of PEG-rhG-CSF in preventing neutropenia caused by chemoradiotherapy

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Published

16-03-2023

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Section

Translational and Clinical Research

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How to Cite

1.
Efficacy and safety of PEG-rhG-CSF in preventing chemoradiotherapy-induced neutropenia in patients with locally advanced cervical cancer. Biomol Biomed [Internet]. 2023 Mar. 16 [cited 2024 Apr. 20];23(2):310–316. Available from: https://www.bjbms.org/ojs/index.php/bjbms/article/view/7859