诊疗指南

2015 ASCO临床指南更新:白细胞生长因子的使用建议

Recommendations for the Use of WBC Growth Factors: American Society of Clinical Oncology Clinical Practice Guideline Update
2015-07-16 13:37 点击次数:1048发表评论

该指南是对ASCO 2006版造血细胞集落刺激因子使用指南的更新。指南解读

 

Neutropenia and its complications, including febrile neutropenia and infection, remain major toxicities associated with myelosuppressive systemic cancer chemotherapy. In a nationwide prospective cohort study, first-cycle febrile neutropenia occurred in 6% of adults with solid tumors being treated with myelosuppressive chemotherapy. Among patients with metastatic solid tumors, incidence of febrile neutropenia during myelosuppressive chemotherapy ranged from 13% to 21% in a large retrospective study. Neutropenic complications require prompt evaluation and treatment with empiric antibiotics and often require hospitalization. The risk of such complications increases in direct proportion to the severity and duration of neutropenia. Hematopoietic colony-stimulating factors (CSFs) have been shown to reduce the duration and severity of neutropenia and the risk of febrile neutropenia and enable delivery of more intensive or dose-dense chemotherapy when indicated. However, concerns with respect to adverse events and costs led the American Society of Clinical Oncology (ASCO) to develop a clinical practice guideline for the use of CSFs in 1994 and updates on four occasions since then. This guideline represents the first major update since 2006 and addresses the strengths and limitations of the use of CSFs across a range of settings in clinical oncology practice on the basis of an exhaustive review of the medical literature. The purpose of this guideline is to foster the appropriate use of these agents based on high-quality evidence from controlled clinical trials and a comprehensive understanding of the specific patient, disease, and treatment factors associated with the risk of neutropenic complications.

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学科代码:肿瘤学   关键词:ASCO 生长因子 集落刺激因子 ,指南 爱思唯尔医学网, Elsevierme
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