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- Title
Therapeutic use of granulocyte colony-stimulating factor (G-CSF) in patients with febrile neutropenia: a comprehensive systematic review for clinical practice guidelines for the use of G-CSF 2022 from the Japan Society of Clinical Oncology.
- Authors
Tsuchihashi, Kenji; Ito, Mamoru; Okumura, Yuta; Nio, Kenta; Ozaki, Yukinori; Nishio, Hiroshi; Ichihara, Eiki; Miura, Yuji; Endo, Makoto; Yano, Shingo; Maruyama, Dai; Yoshinami, Tetsuhiro; Susumu, Nobuyuki; Takekuma, Munetaka; Motohashi, Takashi; Ochi, Nobuaki; Kubo, Toshio; Uchino, Keita; Kimura, Takahiro; Kamiyama, Yutaro
- Abstract
Background: Febrile neutropenia represents a critical oncologic emergency, and its management is pivotal in cancer therapy. In several guidelines, the use of granulocyte colony-stimulating factor (G-CSF) in patients with chemotherapy-induced febrile neutropenia is not routinely recommended except in high-risk cases. The Japan Society of Clinical Oncology has updated its clinical practice guidelines for the use of G-CSF, incorporating a systematic review to address this clinical question. Methods: The systematic review was conducted by performing a comprehensive literature search across PubMed, the Cochrane Library, and Ichushi-Web, focusing on publications from January 1990 to December 2019. Selected studies included randomized controlled trials (RCTs), non-RCTs, and cohort and case–control studies. Evaluated outcomes included overall survival, infection-related mortality, hospitalization duration, quality of life, and pain. Results: The initial search yielded 332 records. Following two rounds of screening, two records were selected for both qualitative and quantitative synthesis including meta-analysis. Regarding infection-related mortality, the event to case ratio was 5:134 (3.73%) in the G-CSF group versus 6:129 (4.65%) in the non-G-CSF group, resulting in a relative risk of 0.83 (95% confidence interval, 0.27–2.58; p = 0.54), which was not statistically significant. Only median values for hospitalization duration were available from the two RCTs, precluding a meta-analysis. For overall survival, quality of life, and pain, no suitable studies were found for analysis, rendering their assessment unfeasible. Conclusion: A weak recommendation is made that G-CSF treatment not be administered to patients with febrile neutropenia during cancer chemotherapy. G-CSF treatment can be considered for patients at high risk.
- Subjects
GRANULOCYTE-colony stimulating factor; FEBRILE neutropenia; CANCER chemotherapy; MEDIAN (Mathematics); OVERALL survival; RANDOMIZED controlled trials
- Publication
International Journal of Clinical Oncology, 2024, Vol 29, Issue 6, p700
- ISSN
1341-9625
- Publication type
Article
- DOI
10.1007/s10147-024-02541-z