| PurposeThe situation of breast cancer patients application of rhG-CSF. Study on the white blood cells (WBC and ANC),NLR, tumor markers (CA15-3, CA125 and CEA),and the ratio of immune cells (CD4+, CD4/CD8, CIK, NK) change after using rhG-CSF. The analysis of the effect of the first line of operation and treatment after third cycles of chemotherapy in patients with breast cancer use rhG-CSF to disease progression-free survival and Overall survival.MethodsA retrospective survey from January 2012 to December 2013, in the tumor hospital of Yunnan province in patients with breast cancer before and after the application of rhG-CSF from white blood cells (WBC, ANC), NLR value, tumor markers (CA15-3, CA125, CEA), the ratio of immune cells (CD4+, CD4/CD8, CIK,NK).Using the software of SPSS 20, statistical comparison before and after treatment changes in white blood cell, NLR, tumor markers and immune cell ratio.From 2000 January to 2006 December, in the tumor hospital of Yunnan province treatment of patients with cytology or pathology of breast cancer,and third cycles of first line operation in the treatment of breast cancer patients chemotherapy, who was analysised of blood cells and tumor marker examination before and after treatment. According to whether the patients use of rhG-CSF during chemotherapy divided into drug group and non drug group. PFS and OS were determined by review or telephone follow-up. The PFS and OS of breast cancer patients with and without the use of rhG-CSF were calculated.Results1.209 patients with breast cancer during the period from 2012 January to 2013 December using rhG-CSF, including 158 passengers (75.6%) without bone marrow suppression were the use of rhG-CSF, there were 1 cases (0.48%) with rhG-CSF white blood cell count of less than 2000/mm3.2.209 patients are recorded in the WBC, ANC and NLR before and after using rhG-CSF. The analysis showed that the after WBC, ANC, NLR were significantly higher than those before the use of rhG-CSF treatment (P< 0.001).According to the usage of rhG-CSF 209 of the data were divided into three groups. The analysis shows that:the group of usage of 200ug d1 and group of usage of 200ug d1-2 & 200ug dl-3 the after WBC, ANC, NLR were significantly higher than those before the use of rhG-CSF treatment (P< 0.001);the group of usage 200ug dl-4 and above there was no significant difference before and after the use of rhG-CSF treatment (P=0.067)3.146 groups of data on tumor markers before and after medication, the results showed that the tumor markers CA15-3, CA125, CEA were no significant difference before and after treatment.4.70 groups of data on immune cell ratio before and after medication, the results showed that the immune cell ratio CD4+, CD4/CD8, CIK, NK were no significant difference before and after treatment.5. January 2000 to December 2006,43 cases of breast cancer patients treated with first line operation, and been followed up the PFS and OS. In the treatment group(25 cases) and untreated group(18 cases) were female, KPS score more than 70 points, the first-line chemotherapy underwent 6 cycles, were not targeted therapy, the median age group of the treatment group patients was 50 years (39-71 years), the untreated group median age group of patients was 47 years (32-64 years); analysis shows that the two groups in age, history, menopause, family history, T staging, N staging,AJCC staging,operation, pathological type, hormone receptor and endocrine therapy had no statistical significance.6. The treatment group patients with WBC、ANC compared with the untreated group were significant differences (P< 0.001); The treatment group patients with NLR compared with the untreated group increased, the difference was statistically significant (P=0.01). The treatment group patients with CA15-3 compared with the untreated group increased, the difference was statistically significant (P=0.011).7.7(28%) cases belong to the treatment group’s 25 cases occurred in patients with disease progression:including 2 cases of regional recurrence; metastasis occurred in 5 cases; 2 cases died,1 cases of tumor related death,1 cases died of acute pancreatic necrosis.7 cases of patients with disease progression:there are 1 patients at the same time the regional recurrence and distant metastasis,1 cases of patients with distant metastasis and death at the same time. The untreated group of 18 patients, there was no local recurrence, regional recurrence, distant metastasis and death.8. PFS and OS of treatment group and untreated group were compared:the patients of treatment group with PFS compared with the untreated group were lower, the difference was statistically significant (P=0.025), there was no significant difference between the two groups in OS (P=0.232). Correlation analysis of PFS, OS with medication or not, there was a correlation between PFS and rhG-CSF (P=0.023), and no correlation with unused rhG-CSF; there was no relationship between OS and drug using (P=0.236).9. rhG-CSF using or not is the influence factors of breast cancer patients with PFS (P=0.016).10.25 cases of patients with the use of rhG-CSF:19 cases (76%) patients with rhG-CSF without bone marrow suppression; there were 3 cases (12%) of rhG-CSF patients at the white blood cell count of less than 2000/mm3.Conclusions1. The use of rhG-CSF significantly increased WBC, ANC and NLR in patients with breast cancer.2. The use of rhG-CSF and the increased of NLR could affect patient’s PFS, should be careful to choose the use of rhG-CSF in clinical work. |
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