Clinical utilization of long-acting granulocyte colony-stimulating factor (pegfilgrastim) prophylaxis in breast cancer patients with adjuvant docetaxel-cyclophosphamide chemotherapy

Ye Won Jeon; Seung Taek Lim; Hongki Gwak; Seon Young Park; Juhee Shin; Hye Sug Han; Young Jin Suh

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저자정보: Ye Won Jeon (The Catholic University of Korea, St. Vincent’s Hospital) Seung Taek Lim (The Catholic University of Korea, St. Vincent’s Hospital) Hongki Gwak (The Catholic University of Korea, St. Vincent’s Hospital) Seon Young Park (The Catholic University of Korea, St. Vincent’s Hospital) Juhee Shin (The Catholic University of Korea, St. Vincent’s Hospital) Hye Sug Han (The Catholic University of Korea, St. Vincent’s Hospital) Young Jin Suh (The Catholic University of Korea, St. Vincent’s Hospital)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.100 No.2

발행연도: 2021.2

수록면: 59 - 66 (8page)

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Purpose: Treatment with 4 cycles of docetaxel and cyclophosphamide (TC) in the adjuvant setting is associated with better outcomes than treatment with doxorubicin and cyclophosphamide (AC). However, Western guidelines have indicated that TC confers a high risk (>20%) of febrile neutropenia (FN), while AC confers an intermediate risk (10%-20%) of FN. Threrefore, we evaluated the incidence of FN and the clinical utilization of pegfilgrastim prophylaxis after adjuvant TC chemotherapy.
Methods: We categorized 201 patients who received adjuvant TC chemotherapy into 3 groups according to the method of prophylaxis and compared neutropenic events, other adverse events, and hospital care costs in the 3 groups.
Results: The incidence of grade 4 neutropenia decreased from 93.0% in patients without prophylaxis to 82.4% in those who received secondary prophylaxis and 16.7% in those who received primary prophylaxis. Although the incidence of FN was not different between patients without prophylaxis and patients who received secondary prophylaxis (15.7% and 14.9%), none of the patients who received primary prophylaxis developed FN. Moreover, a decrease in neutropenic events resulted in a significant decrease in the mean duration of neutropenia (2.50 days to 0.08 days, P < 0.001), the risk of hospitalization (29.8% to 2.2%, P < 0.001), and the mean total hospital care cost for all chemotherapy cycles (790.80 to 486.00 US dollars, P < 0.001).
Conclusion: The use of pegfilgrastim prophylaxis during adjuvant TC chemotherapy is associated with significant decreases in the incidence of neutropenic events, hospitalization, and hospital care cost compared to those seen in patients without prophylaxis.

#Breast neoplasms #Chemotherapy #Febrile neutropenia #Granulocyte colony-stimulating factor

참고문헌 (22)

참고문헌 신청

Early Breast Cancer Trialists’ Collaborative Group / 2005 / Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival:an overview of the randomised trials / Lancet 365:1687~1717

Smith LA / 2010 / Cardiotoxicity of anthracycline agents for the treatment of cancer: systematic review and meta-analysis of randomised controlled trials / BMC Cancer 10:337

Pal SK / 2010 / Emergence of nonanthracycline regimens in the adjuvant treatment of breast cancer / Breast Cancer Res Treat 119:25~32

Smith RE / 2003 / National Surgical Adjuvant Breast and Bowel Project Experience. Acute myeloid leukemia and myelodysplastic syndrome after doxorubicin-cyclophosphamide adjuvant therapy for operable breast cancer: the National Surgical Adjuvant Breast and Bowel Project experience / J Clin Oncol 21:1195~1204

Jones SE / 2006 / Phase III trial comparing doxorubicin plus cyclophosphamide with docetaxel plus cyclophosphamide as adjuvant therapy for operable breast cancer / J Clin Oncol 24:5381~5387

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