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首页> 外文期刊>Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer >Therapeutic use of granulocyte and granulocyte-macrophage colony-stimulating factors in febrile neutropenic cancer patients. A systematic review of the literature with meta-analysis.
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Therapeutic use of granulocyte and granulocyte-macrophage colony-stimulating factors in febrile neutropenic cancer patients. A systematic review of the literature with meta-analysis.

机译：粒细胞和粒细胞-巨噬细胞集落刺激因子在发热性中性粒细胞减少症患者中的治疗用途。通过荟萃分析对文献进行系统回顾。

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The effectiveness of granulocyte and granulocyte-macrophage colony-stimulating factor (G-CSF and GM-CSF) in the treatment of febrile neutropenic cancer patients remains controversial. To assess their role in this condition, we conducted a systematic review of randomised trials published as full papers. A methodological evaluation using a specifically designed quality scale was performed before meta-analysis. Eleven trials were eligible, 8 of which were meta-analysable. The median quality score for the 11 pooled trials was 58.3% (range: 33.3%-68.8%). No significant quality difference was observed between positive (colony-stimulating factor more effective) and negative trials ( P=0.36). No quality difference was observed between the 8 meta-analysable studies and the 3 others, with respective median scores of 59.3% and 50%. No advantage was detected for the use of CSF in terms of mortality from febrile neutropenia, with a relative risk of 0.71 (95% CI 0.44-1.15). The relative risk was 0.66 (95% CI 0.39-1.13) in the G-CSF subgroup and 0.97 (95% CI 0.34-2.79) in the GM-CSF subgroup. Aggregation of the results on infection-related mortality, length of stay in hospital, fever and of neutropenia duration, antibiotic therapy adaptation and duration, superinfection rate and toxicity was not possible owing to the lack of adequate data in the publications. On the basis of this review, we cannot recommend the routine use of G-CSF or GM-CSF in established febrile neutropenia.
机译：粒细胞和粒细胞巨噬细胞集落刺激因子（G-CSF和GM-CSF）在治疗发热性中性粒细胞减少症患者中的有效性尚有争议。为了评估它们在这种情况下的作用，我们对以全文发表的随机试验进行了系统评价。在荟萃分析之前，使用专门设计的质量量表进行了方法学评估。共有11项试验符合条件，其中8项可以进行荟萃分析。 11项汇总试验的中位质量得分为58.3％（范围：33.3％-68.8％）。在阳性试验（更有效的集落刺激因子）和阴性试验之间未观察到明显的质量差异（P = 0.36）。 8项荟萃分析研究与其他3项研究之间未观察到质量差异，中位数分别为59.3％和50％。就发热性中性粒细胞减少症的死亡率而言，使用脑脊液没有优势，相对风险为0.71（95％CI 0.44-1.15）。 G-CSF亚组的相对风险为0.66（95％CI 0.39-1.13），而GM-CSF亚组的相对风险为0.97（95％CI 0.34-2.79）。由于出版物缺乏足够的数据，因此无法汇总与感染相关的死亡率，住院时间，发烧和中性粒细胞减少症的持续时间，抗生素治疗的适应性和持续时间，重复感染率和毒性的结果。根据这项审查，我们不建议在已建立的发热性中性粒细胞减少症中常规使用G-CSF或GM-CSF。

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