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  1. 医学部
  1. 医学部
  2. 学術雑誌掲載論文  (医学部)

Clinical Experience With Preventing Chemotherapy-Induced Neutropenia in Breast Cancer Patients With Different Timings of Pegylated Granulocyte Colony-Stimulating Factor (PEG-G-CSF) Injection: A Case Series

http://hdl.handle.net/10458/0002001836
http://hdl.handle.net/10458/0002001836
5f6a91bc-4cd9-442f-aba4-042455c64bbb
名前 / ファイル ライセンス アクション
20250929-150460-vc1z1r.pdf fulltext (2.6 MB)
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アイテムタイプ 学術雑誌論文 / Journal Article(1)
公開日 2025-10-17
タイトル
タイトル Clinical Experience With Preventing Chemotherapy-Induced Neutropenia in Breast Cancer Patients With Different Timings of Pegylated Granulocyte Colony-Stimulating Factor (PEG-G-CSF) Injection: A Case Series
言語 en
言語
言語 eng
キーワード
言語 en
キーワード breast cancer chemotherapy
キーワード
言語 en
キーワード fibrile neutropenia
キーワード
言語 en
キーワード granulocyte colony-stimulating factor (g-csf)
キーワード
言語 en
キーワード heterochronic follow-up
キーワード
言語 en
キーワード optimal timing
資源タイプ
資源タイプ journal article
アクセス権
アクセス権 open access
著者 冨永, 洋平

× 冨永, 洋平

WEKO 35301
e-Rad_Researcher 90304823

ja 冨永, 洋平
宮崎大学

ja-Kana トミナガ, ヨウヘイ

en Tominaga, Yohei
University of Miyazaki

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古川, 貢之

× 古川, 貢之

WEKO 34654
e-Rad_Researcher 40404446

ja 古川, 貢之
宮崎大学

ja-Kana フルカワ, コウジ

en Furukawa, Koji
University of Miyazaki

Search repository
抄録
内容記述タイプ Abstract
内容記述 Pegfilgrastim (pegylated granulocyte colony-stimulating factor, PEG-G-CSF) is commonly used as prophylaxis for febrile neutropenia (FN) in high-risk chemotherapy regimens for breast cancer. However, the optimal timing of PEG-G-CSF injections has not been established, despite several investigations into the subject. In this study, patients received epirubicin-based breast cancer chemotherapy and underwent routine blood tests on days seven or eight of initial chemotherapy to assess the risk of FN. Four patients experienced significant decreases in white blood cell (WBC) and neutrophil (NE) counts.

To maintain patient safety and relative dose intensity (RDI), the dose was reduced in the second cycle, and PEG-G-CSF administration was moved from day three to day four, as administering PEG-G-CSF within 24 hours to prevent FN is thought to be ineffective. This theory is based on the fact that the WBC and NE expanded by PEG-G-CSF were killed by the remaining chemotherapy. Therefore, we hypothesized that in the next second cycle, administering PEG-G-CSF one day later (day four) after chemotherapy might be effective for these patients. Furthermore, for patients whose blood tests on days seven or eight of the second cycle showed an increase in WBC and NE counts, the chemotherapy dose was increased in the third cycle.

Patients with breast cancer (age range: 41-71 years) were assigned to receive PEG-G-CSF on day three or four of a three-week epirubicin and cyclophosphamide-based chemotherapy regimen (dose-dense epirubicin and cyclophosphamide; 5-fluorouracil, epirubicin, and cyclophosphamide; or basic epirubicin and cyclophosphamide) using heterochronic timing. We then compared WBC and NE counts in the same individuals over time. In all four cases, WBC and NE counts on day seven or eight were much greater with PEG-G-CSF injection on day four than with injection on day three. As per heterochronic follow-up, which has not been reported previously, day four injection of PEG-G-CSF appears more effective than day three injection for preventing neutropenia. However, due to the small number of cases in this series and the confounding factor of the chemotherapy dose in the third cycle being approximately 8% less than that in the first cycle in Case 2, it is difficult to generalize our findings. Hence, future studies with a longitudinal follow-up involving a larger number of cases are required.
言語 en
書誌情報 en : Cureus

巻 17, 号 8, p. e91258, 発行日 2025-08-29
出版者
出版者 Cureus
言語 en
ISSN
収録物識別子タイプ PISSN
収録物識別子 21688184
DOI
関連タイプ isVersionOf
識別子タイプ DOI
関連識別子 https://doi.org/10.7759/cureus.91258
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出版タイプ VoR
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