Use and delivery of granulocyte colony–stimulating factor in breast cancer patients receiving neoadjuvant or adjuvant chemotherapy—single-centre experience

[摘要] BackgroundUse of granulocyte colony-stimulating factor (G-CSF) as primary prophylaxis against chemotherapy-induced neutropenia has significant cost implications. We examined use of G-CSF for early-stage breast cancer patients at our centre. The study also examined the pattern of nurse-led patient teaching with respect to drug self-administration.MethodsPatients who received G-CSF between November 2009 and October 2010 were identified from pharmacy records. After consent had been obtained, electronic charts were examined to extract data on chemotherapy and use of G-CSF. Patients were contacted by telephone to obtain information on the utilization of home-care nursing visits for G-CSF administration.ResultsThe study analyzed 36 patients. Median age was 58 years (range: 31–78 years). Of the 36 patients, 30 (83%) had received adjuvant treatment, and 6 (17%), neoadjuvant treatment. Most patients (71%) received 10 days (range: 7–10 days) of filgrastim. Of the 36 patients, 29 (81%) received G-CSF as primary prophylaxis. In 90% of those patients, primary prophylaxis commenced with the taxane component of treatment. Of the 36 patients, 7 (19%) received G-CSF after neutropenia, including 2 who had febrile neutropenia. In 96% of the patients, injections were received at home with the help of a nurse; those patients were subsequently taught self-injection techniques. The median number of nursing visits was 2 (range: 1–3 visits). Most patients were satisfied with the home care and G-CSF teaching they received. ConclusionsMost of the G-CSF used in breast cancer treatment during the study period was given for primary prophylaxis. A major reason for the decision to use G-CSF appears to have been physician-perceived risk of febrile neutropenia. Delivery of G-CSF by home-care nurses was well received by patients.

[学科分类] 肿瘤学