Kuderer, N.M., Dale, D.C., Crawford, J., & Lyman, G.H. (2007). Impact of primary prophylaxis with granulocyte colony-stimulating factor on febrile neutropenia and mortality in adult cancer patients receiving chemotherapy: A systematic review. Journal of Clinical Oncology, 25, 3158–3167.
To evaluate primary granulocyte colony-stimulating factor (G-CSF) prophylaxis versus a placebo or untreated control group
DATABASES USED: Electronic databases through December 2006: MEDLINE, EMBASE, CANCERLIT, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effect, and Conference Proceedings (American Society of Clinical Oncology and American Society of Hematology). In addition, references from included articles and relevant published reports were hand searched, and references from leaders in the field were solicited. The literature search had no language restrictions.
INCLUSION CRITERIA:
EXCLUSION CRITERIA:
FINAL NUMBER STUDIES INCLUDED = 17 RCTs of primary prophylactic G-CSF
TOTAL PATIENTS INCLUDED IN REVIEW = 3,493 patients
KEY SAMPLE CHARACTERISTICS:
The occurrence of FN was reported as an outcome in 15 trials with 3,182 patients.
Infection-related mortality was reported as an outcome in 12 trials including 1,454 control patients and 1,463 patients receiving G-CSF.
Early mortality was reported in 13 trials with 3,122 patients.
Relative dose intensity (RDI) was reported as an outcome in 10 trials. The average RDI among control patients in these studies ranged from 71.0%–95.0%, with a mean RDI of 86.7% (median RDI: 88.5%).
Bone or musculoskeletal pain during the course of chemotherapy was reported as an outcome in 14 trials including 3,029 patients.