摘要
目的：探讨国产重组人粒细胞集落刺激因子（rhG-CSF）预防乳腺癌术后辅助化疗后中性粒细胞减少症的应用策略。方法：选择乳腺癌术后辅助化疗、第1个周期中曾出现4度中性粒细胞减少者32例，化疗方案为AC、FEC100和EC方案。采用3种预防应用rhG-CSF的方法：皮下注射300μg／d，方法1为化疗后第2～15天注射；方法2为第3～10天注射；方法3为第6～13天注射。32例患者随机分成两组，分别为1～3比较组和2～3比较组，在化疗的第2、3个周期采用自身交叉对照法进行比较。结果：方法1的中性粒细胞绝对数（ANC）化疗后无明显下降，在第16～18天时出现高峰。方法2的ANC化疗后出现短暂上升，第10～12天最高，之后下降较明显。方法3的ANC变化较平稳，无明显下降也无明显高峰；方法1和方法3的平均ANC最低值、ANC＜2．0×10^9 L^-1持续天数及ANC减少症发生率均相似，方法2的平均ANC最低值明显低于方法3，P=0．033；方法1的骨骼肌肉疼痛和注射局部硬结的发生率明显高于方法3，P=0．023和0，029。结论：3种方法总体上均显示了预防化疗后ANC减少的作用，方法3疗效好且不增加不良反应发生率，相对于其他两种方法而言，是一种更好的预防用药策略。
OBJECTIVE： To explore the best strategy of domestic rhG-CSF in preventing neutropenia caused by breast cancer adjuvant chemotherapy. METHODS： Thirty-two cases who were undergoing adjuvant chemotherapy and showed 4 grade neutropenia in the first cycle were chosen. The regiments were AC, FEC100 or EC. 300 μg rhG-CSF was hypodermic injected per day and three methods of applying rhG-CSF were designed： Method 1 was applying rhG-CSF from 2nd to 15th after chemotherapy, Method 2 was from 3rd to 10th and Method 3 was from 6th to 13th. The 32 cases were divided into two groups randomly. One was Method 1-3 comparison group and the other was Method 2-3 comparison group. Cross-over trial was designed in the second and third cycles of chemotherapy, RESULTS： The absolute neutrophil count （ANC） showed no apparent decrease and a peak appeared on 16th-18th days in Method 1. ANC increased on 10th-12th and then decreased rapidly in Method 2. ANC changed steadily in Method 3. The ANC nadir, ANC〈2.0×10^9 L^-1 duration and rate of neutropenia were similar between Method 1 and 3. The ANC nadir in Method 2 was lower significantly than that in Method 3（P=0, 033）, Ostalgia, courbature and induration were much more in Method 1 than in Method 3 （P= 0. 023, 0. 029）. CONCLUSlON： These three methods can all prevent neutropenia and Method 3 is relatively a better strategy.
出处
《中华肿瘤防治杂志》
CAS
2006年第16期1250-1252,共3页
Chinese Journal of Cancer Prevention and Treatment
作者简介
周清，女，河北徐水人，博士，主治医师，主要从事肺癌、乳腺癌多学科综合治疗工作。Tel：86—20—83827812—58050 Fax：86—20—83844620 E-mail：gzzhouqing@126.com
【通讯作者简介】吴一龙，男，广东汕头人，主任医师，博士生导师，主要从事肿瘤多学科综合治疗工作。Tel／Fax：86—20—83877557 E-mail：gzyilong@hotmail.com
