Abstract 574P
Background
Myelosuppressive chemotherapy often causes neutropenia leading to febrile neutropenia (FN), a severe complication linked to high infection and mortality risks. Regular FN risk assessment and G-CSF administration are crucial for managing FN. However, adherence to FN guidelines and G-CSF use in Chinese clinical practice is inadequate. This study evaluates how Chinese cancer patients undergoing chemotherapy adhere to clinical recommendations for FN risk assessment, prophylactic G-CSF use, and G-CSF therapy.
Methods
A multicenter retrospective observational study collected tumor patients receiving PEG-rhG-CSF prophylaxis post-chemotherapy from June 2022 to January 2023. Blood test analyses during chemotherapy assessed FN incidence. Categorical variables were presented as percentages, continuous variables as means ± SD. Statistical analysis utilized Stata/MP 17.0.
Results
The study enrolled 17,713 tumor patients from 589 hospitals across eight cancer types. Average age was 56.7 years; females constituted 67.9%. G-CSF prophylaxis was followed by 76.3%. PEG-rhG-CSF prophylaxis rates were 93.0% for high-risk FN patients and 75.8% for low-risk. Lowest prophylactic usage occurred in low-risk gastric cancer (52.8%) and colorectal cancer (61.4%). PEG-rhG-CSF 6mg (77.0%) and PEG-rhG-CSF 3mg (23.0%) were predominantly used for FN prevention. Highest PEG-rhG-CSF 3mg usage was in high-risk osteosarcoma (31.6%) and gastric cancer (29.4%) patients receiving adjuvant therapy. In therapeutic G-CSF choices, 69.0% opted for PEG-rhG-CSF 6mg and 31.0% for PEG-rhG-CSF 3mg for FN.
Conclusions
Despite guidelines, significant patient non-compliance exists in assessing FN risk and using G-CSF. High usage of 3mg PEG-rhG-CSF in osteosarcoma and gastric cancer differs from Chinese Society of Clinical Oncology (CSCO) guideline 6mg recommendation, affecting outcomes and safety. Standardizing dosage is crucial for optimal treatment planning, alongside personalized prevention strategies for varied cancer types and risks, enhancing treatment efficacy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.