Abstract
Background: Recombinant human granulocyte colony-stimulating factor (rhG-CSF), which can reduce neutropenia events, is widely used in cancer patients receiving chemotherapy. However, the effects of rhG-CSF on distant organ metastasis (DOM) in non-small cell lung cancer (NSCLC) patients following postoperative chemotherapy remain unclear.Methods: A retrospective cohort study was performed on NSCLC patients who suffered complete surgical resection and postoperative system chemotherapy at The First Affiliated Hospital of Nanchang University between 1 January 2012 and 31 December 2017. The effect of rhG-CSF on DOM was assessed, regulating with other confounding factors using Cox regression analyses.Results: We identified 307 NSCLC patients who received postoperative system chemotherapy (n=246 rhG-CSF group, n=61 No rhG-CSF group). The incidence of DOM in postoperative NSCLC patients with rhG-CSF treatment was observably higher than without rhG-CSF (48.3% vs. 27.9%, p<0.05). Univariate regression analysis revealed that rhG-CSF and clinical stage were the independent risk factor of Metastasis-free survival (MFS) (p<0.05). rhG-CSF users had a higher risk of DOM (adjusted HR: 2.33, 95% CI: 1.31-4.15) than nonusers of rhG-CSF. The association between rhG-CSF and risk of DOM was significant only among patients presenting with myelosuppression (HR: 3.34, 95% CI: 1.86-6.02), not among those without myelosuppression (HR: 0.71, 95% CI: 0.17-2.94, Interaction p-value<0.01). The risk increased with higher dosage density of rhG-CSF use, comparing those using rhG-CSF versus no users (p for trend<0.001).Conclusion These analyses indicated that rhG-CSF use is related to DOM following postoperative chemotherapy in NSCLC.
Pregnancy And Neonatal Outcomes Of hMG Stimulation With Or Without Letrozole In Endometrial Preparation For Frozen–Thawed Embryo Transfer In Ovulatory Women: A Large Retrospective Cohort Study
