ZHANG Jing%YU Shi-ying

Objective: To investigate the clinicians’ awareness about G-CSF (granulocyte colony-stimulating factor) use and the current G-CSF use in cancer patients receiving chemotherapy and radiotherapy, and evaluate the compliance with the guidelines for the use of G-CSF in the clinicians of oncology. Methods: The self-designed questionnaire based on 2006 ASCO (American Society of Clinical Oncology) and 2012 NCCN (National Comprehensive Cancer Network) guidelines for G-CSF was conducted to investigate the clinicians’ knowledge of the use of G-CSF for cancer patients in 31 secondary/tertiary hospitals in China between June 2012 and November 2012, and a further survey of the use of G-CSF for cancer patients receiving chemotherapy and radiotherapy in a tertiary hospital was perfomed to evaluate the compliance with the guidelines. Results: Total of 218 clinicians efficiently completed the questionnaire. Of these 218 clinicians, 205 completed the questionnaire on chemotherapy and 85 on radiotherapy. For assessment of FN (febrile neutropenia) risk in patinets prior to first chemotherapy cycle, 71.4% of the clinicians were clear about this assessment; 50.0%, 62.7% and 2.9% had the knowledge about primary and secondary prophylactic use and therapeutic use of G-CSF, respectively. Approximately 80.0% of the clinicians administered G-CSF for neutropenia ocurred in patients receiving concurrent chemoradiotherapy regardless of radiation sites. There were 222 patients treated with 724 chemotherapy cycles included in the survey. In prophylactic use, 259 (35.8%) cases used G-CSF that the guideline doesn’t recommend, which belonged to excessive use, the doses accounting for 59.7% of the totle prophylactic use; 105 (14.5%) didn’t use while the guideline recommend, belonging to lack of use. In therapeutic use, only 3.1% were standardized, accounting for 7.4% of the total dose, and the remaining 92.6% were excessive use. Of 35 patients receiving radiotherapy, 97.1% were treated with G-CSF when neutropenia occurred; 3 patients undergoing concurrent chemoradiotherapy including mediastinum used G-CSF when neutropenia appeared, which wasn’t in conformity with ASCO 2006 guideline. The dose of G-CSF used in majority of the patients didn’t meet the guidelines. Conclusion: This survey indicates that the poor compliance with the recommendations of guidelines for the use of G-CSF in clinicians of oncology. There is a signifcant difference between the current clinical practice and the recommendations of guidelines. The clinicians should increase the understanding and promote the proper use of G-CSF. DOI:10.3781/j.issn.1000-7431.2013.05.010