Email this article The importance of the prevention of treatment induced neutropenia in patients with malignant neoplasms of the head and neck
- Issue: Vol 23, No 2 (2021)
- Pages: 356-360
- Section: CLINICAL ONCOLOGY
- URL: https://journals.rcsi.science/1815-1434/article/view/77948
- DOI: https://doi.org/10.26442/18151434.2021.2.201018
- ID: 77948
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Abstract
Hematological toxicity is the most common complication of chemotherapy. The most dangerous manifestation of hematological toxicity is febrile neutropenia (FN). FN reduces survival, increases the risk of death, the frequency of infectious complications, hospitalizations, the cost of treatment. The risk of FN should be assessed before the beginning of the therapy, using the general algorithm from the protocol to prevent FN applying the granulocyte colony-stimulating factors (G-CSF). G-CSF for the prevention is required throughout all cycles of myelosuppressive therapy. For the prevention of FN, the most effective is the use of PEGylated G-CSF. Patients with head and neck squamous cell carcinoma, receiving the TPF or DCF regimen, combined with docetaxel and cisplatin, are included in the group of routine primary prophylaxis for neutropenia. In case of developing 3–4 grade FN in these patients, the use of PEGylated G-CSF (empegfilgrastim) is preferable.
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Fig. 1. The RTOG 0129 study (from 2002 to 2005). Patients with head and neck squamous cell carcinoma (HNSCC). The comparison of the efficacy of competitive chemoradiotherapy depending on the number of chemotherapy courses within the competitive mode in patients with stage III–IV HNSCC.
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Fig. 2. The analysis of the impact of the granulocyte colony-stimulating factors on overall survival and mortality.
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Fig. 3. The comparison of the efficacy of filgrastim and Extimia® (the data of the registration study of empegfilgrastim): a – the incidence of 3-4 grade neutropenia after each of the 4 cycles of CT in the groups of Extimia® and filgrastim; b – the frequency of neutropenia, infections and the application of antibiotics.
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Fig. 4. The safety profiles of Extimia® and filgrastim (the data of the registration study of empegfilgrastim).
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