Primary prophylaxis with G-CSF for patients with non-round cell soft tissue sarcomas: a systematic review for the Clinical Practice Guidelines for the Use of G-CSF 2022 of the Japan Society of Clinical Oncology

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2024年6月12日

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Takeshi Hirose,
Mamoru Ito,
Kenji Tsuchihashi,
Yukinori Ozaki,
Hiroshi Nishio,
Eiki Ichihara,
Yuji Miura,
Shingo Yano,
Dai Maruyama,
Tetsuhiro Yoshinami,
Nobuyuki Susumu,
Munetaka Takekuma,
Takashi Motohashi,
Eishi Baba,
Nobuaki Ochi,
Toshio Kubo,
Keita Uchino,
Takahiro Kimura,
Yutaro Kamiyama,
Shinji Nakao,
Shinobu Tamura,
Hitomi Nishimoto,
Yasuhisa Kato,
Atsushi Sato,
Toshimi Takano,
Makoto Endo

摘要

Background

Granulocyte colony-stimulating factor (G-CSF) is an essential supportive agent for chemotherapy-induced severe myelosuppression. We proposed two clinical questions (CQ): CQ #1, “Does primary prophylaxis with G-CSF benefit chemotherapy for non-round cell soft tissue sarcoma (NRC-STS)?” and CQ #2, “Does G-CSF-based intensified chemotherapy improve NRC-STS treatment outcomes?” for the Clinical Practice Guidelines for the Use of G-CSF 2022 of the Japan Society of Clinical Oncology.

Methods

A literature search was performed on the primary prophylactic use of G-CSF for NRC-STSs. Two reviewers assessed the extracted papers and analyzed overall survival, incidence of febrile neutropenia, infection-related mortality, quality of life, and pain.

Results

Eighty-one and 154 articles were extracted from the literature search for CQs #1 and #2, respectively. After the first and second screening, one and two articles were included in the final evaluation, respectively. Only some studies have addressed these two clinical questions through a literature review.

Conclusion

The clinical questions were converted to future research questions because of insufficient available data. The statements were proposed: “The benefit of primary G-CSF prophylaxis is not clear in NRC-STS” and “The benefit of intensified chemotherapy with primary G-CSF prophylaxis is not clear in NRC-STSs.” G-CSF is often administered as primary prophylaxis when chemotherapy with severe myelosuppression is administered. However, its effectiveness and safety are yet to be scientifically proven.