Optimal schedule for administering granulocyte colony-stimulating factor in chemotherapy-induced neutropenia in non-small-cell lung cancer.
A prospective randomized study was conducted to determine the optimal schedule of rhG-CSF (recombinant human granulocyte colony-stimulating factor). A group of 33 lung cancer patients treated with MVP therapy (mitomycin, vindesine, and cisplatin) were randomly assigned to three groups: an early prophylaxis group in which rhG-CSF was initiated on day 2 of the MVP cycle; a late prophylaxis group in which rhG-CSF was initiated on day 8; and a therapeutic group in which rhG-CFS was initiated after the onset of neutropenia. Ten patients who had received MVP therapy without rhG-CSF were also analyzed as a no-support group. The incidence of neutropenia was 80% (16/20 courses) in the early prophylaxis group, 44% (8/18) in the late prophylaxis group, 94% (17/18) in the therapeutic group, and 94% (16/17) in the no-support group. The incidence of neutropenia in the late prophylaxis group was less than in the early prophylaxis group (P<0.05), the therapeutic group (P<0.01), and the no-support group (P<0.01). The late prophylactic rhG-CSF schedule was therefore more effective in countering neutropenia than either the early prophylactic or therapeutic schedule.
Soda
H
H
Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Oka
M
M
Fukuda
M
M
Kinoshita
A
A
Sakamoto
A
A
Araki
J
J
Fujino
S
S
Itoh
N
N
Watanabe
K
K
Kanda
T
T
Nakano
M
M
Hara
K
K
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008937:Mitomycins / Q000008:administration & dosage / Q000009:adverse effects; D009503:Neutropenia / Q000139:chemically induced / Q000517:prevention & control*; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D014751:Vindesine / Q000008:administration & dosage / Q000009:adverse effects
D008937:Mitomycins; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D002945:Cisplatin; D014751:Vindesine