Discussion
adenocarcinoma, cervical cancer, neutropenia, leukopenia
NEUTROPENIA, LEUKOPENIA, ADVERSE EFFECTS, CERVICAL CANCER, ADENOCARCINOMA, LYMPH NODE METASTASIS, PRIMARY TUMOR
In this study, the prophylactic use of PEG-rhG-CSF after every chemotherapy cycle effectively reduced the incidence of grade 1–4 neutropenia and delay of chemotherapy in patients with cervical cancer treated by cisplatin and docetaxel. The use of PEG-rhG-CSF resulted in high levels and fast recovery of neutrophils and low incidence of grade 1–4 neutropenia. There were no severe adverse effects of PEG-rhG-CSF treatment.Since 1999, CCRT with cisplatin has become the standard of care for patients receiving radical therapy for LACC. However, in patients with poor prognostic factors, such as lymph node metastasis, large primary tumor size, adenocarcinoma pathologic type, and FIGO stage III–IVA, concurrent chemotherapy using single-agent cisplatin cannot significantly improve the survival rate [In the past, rhG-CSF was used to prevent and treat leukopenia and FN caused by chemotherapy. Koensgen et al. [The plasma half-life of PEG-rhG-CSF is extended to 47 h, and several clinical studies have confirmed that one dose per chemotherapy cycle can effectively prevent neutropenia [In the present study, there was no grade 3–4 neutropenia in patients who received prophylactic PEG-rhG-CSF, and the incidence of grade 1–4 neutropenia was significantly lower in the PEG-rhG-CSF arm (19/79, 24.05%) than in the rhG-CSF arm (41/72, 56.94%). Moreover, the incidence of delay in chemotherapy was significantly lower in the PEG-rhG-CSF arm (0/79, 0%) than in the rhG-CSF arm (8/72, 11.11%). The results of this study showed that compared with multiple doses of short-acting rhG-CSF, one prophylactic administration of PEG-rhG-CSF per chemotherapy cycle resulted in better bone marrow protection. The consensus of Chinese experts on the use of pegylated granulocyte stimulating factor during CCRT does not recommend the use of PEG-rhG-CSF during the weekly chemotherapy regimen of CCRT [In this study, we recorded the dynamic changes in neutrophils during chemoradiotherapy and found a relatively high level and rapid increase of the ANC after the end of pelvic irradiation in the PEG-rhG-CSF arm. These results were similar to those in the study by Zou et al. [