TY - JOUR
T1 - Therapeutic use of granulocyte colony-stimulating factor (G-CSF) in patients with febrile neutropenia
T2 - a comprehensive systematic review for clinical practice guidelines for the use of G-CSF 2022 from the Japan Society of Clinical Oncology
AU - Tsuchihashi, Kenji
AU - Ito, Mamoru
AU - Okumura, Yuta
AU - Nio, Kenta
AU - Ozaki, Yukinori
AU - Nishio, Hiroshi
AU - Ichihara, Eiki
AU - Miura, Yuji
AU - Endo, Makoto
AU - Yano, Shingo
AU - Maruyama, Dai
AU - Yoshinami, Tetsuhiro
AU - Susumu, Nobuyuki
AU - Takekuma, Munetaka
AU - Motohashi, Takashi
AU - Ochi, Nobuaki
AU - Kubo, Toshio
AU - Uchino, Keita
AU - Kimura, Takahiro
AU - Kamiyama, Yutaro
AU - Nakao, Shinji
AU - Tamura, Shinobu
AU - Nishimoto, Hitomi
AU - Kato, Yasuhisa
AU - Sato, Atsushi
AU - Takano, Toshimi
AU - Baba, Eishi
N1 - Publisher Copyright:
© The Author(s) under exclusive licence to Japan Society of Clinical Oncology 2024.
PY - 2024/6
Y1 - 2024/6
N2 - 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.
AB - 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.
KW - Febrile neutropenia
KW - G-CSF
KW - Therapeutic use
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U2 - 10.1007/s10147-024-02541-z
DO - 10.1007/s10147-024-02541-z
M3 - Article
C2 - 38696053
AN - SCOPUS:85192066314
SN - 1341-9625
VL - 29
SP - 700
EP - 705
JO - International Journal of Clinical Oncology
JF - International Journal of Clinical Oncology
IS - 6
ER -