{Reference Type}: Journal Article
{Title}: Therapeutic use of granulocyte colony-stimulating factor (G-CSF) in patients with febrile neutropenia: a comprehensive systematic review for clinical practice guidelines for the use of G-CSF 2022 from the Japan Society of Clinical Oncology.
{Author}: Tsuchihashi K;Ito M;Okumura Y;Nio K;Ozaki Y;Nishio H;Ichihara E;Miura Y;Endo M;Yano S;Maruyama D;Yoshinami T;Susumu N;Takekuma M;Motohashi T;Ochi N;Kubo T;Uchino K;Kimura T;Kamiyama Y;Nakao S;Tamura S;Nishimoto H;Kato Y;Sato A;Takano T;Baba E;
{Journal}: Int J Clin Oncol
{Volume}: 29
{Issue}: 6
{Year}: 2024 Jun 2
{Factor}: 3.85
{DOI}: 10.1007/s10147-024-02541-z
{Abstract}: <B>BACKGROUND: </B>Febrile neutropenia represents a critical oncologic emergency, and its management is pivotal in cancer therapy. In several guidelines, the use of granulocyte colony-stimulating factor (G-CSF) in patients with chemotherapy-induced febrile neutropenia is not routinely recommended except in high-risk cases. The Japan Society of Clinical Oncology has updated its clinical practice guidelines for the use of G-CSF, incorporating a systematic review to address this clinical question.<BR><B>METHODS: </B>The systematic review was conducted by performing a comprehensive literature search across PubMed, the Cochrane Library, and Ichushi-Web, focusing on publications from January 1990 to December 2019. Selected studies included randomized controlled trials (RCTs), non-RCTs, and cohort and case-control studies. Evaluated outcomes included overall survival, infection-related mortality, hospitalization duration, quality of life, and pain.<BR><B>RESULTS: </B>The initial search yielded 332 records. Following two rounds of screening, two records were selected for both qualitative and quantitative synthesis including meta-analysis. Regarding infection-related mortality, the event to case ratio was 5:134 (3.73%) in the G-CSF group versus 6:129 (4.65%) in the non-G-CSF group, resulting in a relative risk of 0.83 (95% confidence interval, 0.27-2.58; p = 0.54), which was not statistically significant. Only median values for hospitalization duration were available from the two RCTs, precluding a meta-analysis. For overall survival, quality of life, and pain, no suitable studies were found for analysis, rendering their assessment unfeasible.<BR><B>CONCLUSIONS: </B>A weak recommendation is made that G-CSF treatment not be administered to patients with febrile neutropenia during cancer chemotherapy. G-CSF treatment can be considered for patients at high risk.