Clinical practice guidelines for the use of colony-stimulating factors in cancer treatment: Implications for oncology nurses.
Chemotherapy-induced neutropenia (CIN) is a common and serious toxicity of cancer chemotherapy. It can lead to febrile neutropenia (FN), which often requires patients to be hospitalised for intravenous antibiotic therapy. Chemotherapy dose reductions or delays, which can compromise clinical outcomes, may also result from CIN and FN. Prophylactic use of colony-stimulating factors (CSFs) reduces the incidence, duration, and severity of FN, and there is evidence that it helps maintain scheduled chemotherapy dose delivery. In 2006, three organisations published new or updated guidelines for the use of CSFs in cancer treatment. Each recommends that FN risk be determined individually for each patient, taking into account patient- and disease-specific risk factors, the chemotherapy regimen, and treatment intent. Particular consideration should be given to patients who are > or =65 years old, receiving chemotherapy regimens associated with > or =20% risk of FN, receiving dose-dense chemotherapy, and receiving treatment that is adjuvant, potentially curative, or intended to prolong survival. Accordingly, oncology nurses can play an important role in assessing and identifying patients at risk for FN before every chemotherapy cycle. There is evidence that, regardless of practice type or size, implementing guidelines for CSF use within a multidisciplinary team improves patient outcomes.
Kearney
Nora
N
Cancer Care Research Centre, University of Stirling, Unit 1, Scion House, Stirling FK9 4NF, Scotland. nora.kearney@stir.ac.uk
Friese
Christopher
C
D000465:Algorithms; D000970:Antineoplastic Agents / Q000009:adverse effects; D015400:Clinical Nursing Research; D003115:Colony-Stimulating Factors / Q000009:adverse effects / Q000627:therapeutic use*; D003663:Decision Trees; D004334:Drug Administration Schedule; D016903:Drug Monitoring; D019317:Evidence-Based Medicine; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D009503:Neutropenia / Q000139:chemically induced / Q000453:epidemiology / Q000628:therapy*; D024802:Nurse's Role; D009730:Nursing Assessment; D009859:Oncology Nursing / Q000458:organization & administration*; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D018570:Risk Assessment
D000970:Antineoplastic Agents; D003115:Colony-Stimulating Factors