乳がん化学療法FEC100におけるG-CSF製剤の使用評価

概要

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In consideration of the difference between the 2006 American Society of Clinical Oncology guideline on the use of hematopoietic colony-stimulating factors (CSF) and the Japanese medical insurance regulation, we studied the appearance of neutropenia and the use of G-CSF in breast cancer patients undergoing FEC100 therapy as neoadjuvant or adjuvant chemotherapy. All patients undergoing FEC100 therapy developed neutropenia of grade 3 or 4. As febrile neutropenia (FN) occurred in the first course in which the start of G-CSF administration was delayed, the timing of G-CSF administration during the course was adjusted. We found that administering G-CSF early on was more effective than administering it after the appearance of neutropenia to prevent FN and severe neutropenia. The use of G-CSF in this manner enabled FEC100 therapy to be accomplished without dose-reduction in the breast cancer patients. Our findings suggest that the preventive administration of G-CSF is very useful in FEC100 therapy and that if it is used in accordance with the Japanese medical insurance regulation, it may be difficult to prevent the appearance of serious neutropenia and to continue FEC100 therapy at optimum strength.
日本医療薬学会の論文
2009-01-10