Primary G-CSF prophylaxis for adjuvant TC or FEC-D chemotherapy outside of clinical trial settings: a systematic review and meta-analysis.
Background: Variable febrile neutropenia (FN) rates reported with adjuvant TC (taxotere®, cyclophosphamide) and FEC-D (5-flurouracil, epirubicin, cyclophosphamide, docetaxel) outside of clinical trials have precluded definitive recommendations for primary G-CSF (granulocyte colony-stimulating factor...
| Publicado en: | Supportive Care in Cancer Vol. 20; no. 10; pp. 2523 - 2531 |
|---|---|
| Autores principales: | , , , , , |
| Formato: | research systematic review Journal Article |
| Publicado: |
Springer Nature
Oct2012
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104364658&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104364658 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09414355 O1J jtl: Supportive Care in Cancer issn: 09414355 maglogo: N pubinfo: dt: Oct2012 vid: 20 iid: 10 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104364658 NLM22252548 2011669319 10.1007/s00520-011-1375-6 NLM22252548 104364658 ppf: 2523 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Primary G-CSF prophylaxis for adjuvant TC or FEC-D chemotherapy outside of clinical trial settings: a systematic review and meta-analysis. aug: au: Younis T Rayson D Thompson K Younis, Tallal Rayson, Daniel Thompson, Kara affil: Atlantic Clinical Cancer Research Unit, Dalhousie University, Halifax, Nova Scotia, Canada sug: subj: Antineoplastic Agents, Combined Adverse Effects Fever Prevention and Control Granulocyte Colony-Stimulating Factor Therapeutic Use Neutropenia Prevention and Control Adult Aged Antineoplastic Agents, Combined Administration and Dosage Cyclophosphamide Administration and Dosage Doxorubicin Administration and Dosage Fever Chemically Induced Fluorouracil Administration and Dosage Human Hydrocarbons Administration and Dosage Medline Meta Analysis Middle Age Neutropenia Chemically Induced Systematic Review Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years ab: Background: Variable febrile neutropenia (FN) rates reported with adjuvant TC (taxotere®, cyclophosphamide) and FEC-D (5-flurouracil, epirubicin, cyclophosphamide, docetaxel) outside of clinical trials have precluded definitive recommendations for primary G-CSF (granulocyte colony-stimulating factor) prophylaxis in most jurisdictions. A systematic review and meta-analysis was conducted to assess: (a) FN rates associated with TC and FEC-D without primary G-CSF prophylaxis outside of clinical trial settings, and (b) the potential impact of G-CSF prophylaxis on FN prevention.Methods: A MEDLINE search was conducted and major conference abstracts were reviewed up to June 15th 2011 to identify all relevant English-language studies. Random- and fixed-effects meta-analysis models were performed.Results: Nine hundred two patients treated with TC and 1342 with FEC-D from 13 to 9 studies, respectively, were included. The pooled random-effects meta-analysis estimates of FN rates for TC and FEC-D without G-CSF were 29% (95% CI 24-35%) and 31% (95% CI 27-35%), with a 76% (RR = 0.24, 95% CI 0.14-0.41) and 63% (RR = 0.37, 95% CI 0.11-1.24) relative risk reduction with G-CSF, respectively.Conclusion: In routine clinical practice, TC and FEC-D without G-CSF are associated with FN rates exceeding the 20% threshold for which primary G-CSF prophylaxis is commonly recommended, and are considerably higher than those reported in pivotal clinical trials. pubtype: Academic Journal doctype: meta analysis research systematic review Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|