Abstract：
No study has evaluated the effect of therapeutic granulocyte colony-stimulating factor (G-CSF) in preventing recurrence of febrile neutropenia (FN) and survival outcomes in gynecologic cancer patients. Objective of this study is to optimize and to identify the use of G-CSF and identify the critical factors for preventing the recurrence of FN in women undergoing chemotherapy for the treatment of gynecologic cancer. The medical records of consecutive patients who underwent chemotherapy for the treatment of gynecologic cancer and experienced FN at least once were retrospectively reviewed. Clinico-laboratory variables were compared between those with and without recurrence of FN to identify risk factors for the recurrence and the most optimal usage of G-CSF that can prevent FN. Student t test, χ2 test, and multivariate Cox regression analysis were used. A total of 157 patients who met the inclusion criteria were included. Of 157, 49 (31.2%) experienced recurrence of FN. Age ≥55 years (P = .043), previous lines of chemotherapy ≤1 (P = .002), thrombocytopenia (P = .025), total dose (P = .003), and maximum daily dose (P = .009) of G-CSF were significantly associated with recurrence of FN. Multiple regression analysis showed that age ≥55 years (HR, 2.42; 95% CI, 1.14-5.14; P = .022), previous chemotherapy ≤1 (HR, 4.01; 95% CI, 1.40-11.55; P = .010), and maximum daily dose of G-CSF ≤600 μg (HR, 5.18; 95% CI, 1.12-24.02; P = .036) were independent risk factors for recurrent FN. Multivariate Cox regression analysis showed that a maximum daily dose of G-CSF ≤600 μg was the only independent risk factor for short recurrence-free survival of FN (HR, 4.75; 95% CI, 1.15-19.56; P = .031). Dose-dense administration of G-CSF >600 μg/day could prevent recurrence of FN in women who undergo chemotherapy for the treatment of gynecologic cancer and FN. Old age and FN at early lines of chemotherapy seem to be associated with FN recurrence.
摘要：
尚无研究评估治疗性粒细胞集落刺激因子（G-CSF）在预防妇科癌症患者发热性中性粒细胞减少症（FN）复发和生存结局中的作用。本研究的目的是优化和确定G-CSF的使用，并确定预防妇科癌症化疗妇女FN复发的关键因素。回顾性回顾了连续接受化疗治疗妇科癌症并至少经历过一次FN的患者的病历。比较了有和没有FN复发的患者之间的临床实验室变量，以确定复发的危险因素以及可以预防FN的G-CSF的最佳使用。学生t检验,χ2检验,采用多因素Cox回归分析。共纳入157例符合纳入标准的患者。157，49（31.2％）经历了FN复发。年龄≥55岁（P=.043），先前的化疗路线≤1（P=0.002），血小板减少症（P=0.025），总剂量（P=0.003），G-CSF的最大日剂量（P=.009）与FN的复发显着相关。多元回归分析显示年龄≥55岁(HR,2.42；95%CI，1.14-5.14；P=0.022），既往化疗≤1(HR，4.01；95%CI，1.40-11.55；P=.010），G-CSF的最大日剂量≤600μg(HR，5.18；95%CI，1.12-24.02；P=0.036）是FN复发的独立危险因素。多因素Cox回归分析显示，最大日剂量G-CSF≤600μg是FN无复发生存期的唯一独立危险因素（HR，4.75；95%CI，1.15-19.56；P=0.031）。剂量密集的G-CSF>600μg/天可以预防接受化疗以治疗妇科癌症和FN的女性的FN复发。化疗早期的年龄和FN似乎与FN复发有关。
