精巣腫瘍化学療法時の好中球減少に対するrG-CSF(ノイトロジン注)の至適投与法の検討

Abstract

Indiana大学病期分類に基づくminimalもしくはmoderate extentの精巣腫瘍15例に対し, 初回化学療法としてBEP療法を行い, その際のrG-CSFの効果を検討した.rG-CSF投与法として, A群:化学療法各コース6日目より投与する, 及びB群:化学療法施行後, 好中球数が1, 500/mm3以下となった時点より投与するの2群に分けて比較検討した.A群はB群に比較して2コース目以降に有意に白血球数の減少が軽減し, 口内炎の発生頻度が少なかった.しかし, 両群とも本剤の併用により重篤な副作用を引き起こすことなく化学療法が完遂できた

A prospective randomized study on the administration of recombinant granulocyte colony stimulating factor (rG-CSF) was conducted on 15 patients with testicular germ cell tumors. The clinical stagings of all patients except one were minimal to moderate extent according to the Indiana University staging system. Combination chemotherapy using bleomycin, etoposide and cisplatinum (BEP) was performed as the initial treatment on the eligible patients. rG-CSF was administered by two different methods; 1) routine administration on the 6th day after BEP chemotherapy (group A), and 2) the same method, but after granulocytopenia of 1, 500/mm3 had developed (group B). The administration of rG-CSF in group A significantly reduced the severity of leucocytopenia and also the incidence of stomatitis compared with group B. Although rG-CSF produced no significant side effects, the thrombocytopenia was prominent in the group A patients (not significant). BEP chemotherapy itself is an easily-tolerable and well established method for treating young adult patients. The method used in group B seems to be suitable in situations where thrombocytopenia and cost effectiveness.