Colony-stimulating factors for chemotherapy-induced febrile neutropenia: A meta-analysis of randomized controlled trials

Colony-stimulating factors for chemotherapy-induced febrile neutropenia: A meta-analysis of randomized controlled trials

Autor Clark, OAC Google Scholar
Lyman, G. H. Google Scholar
Castro, A. A. Google Scholar
Clark, LGO Google Scholar
Djulbegovic, B. Google Scholar
Instituição Univ Rochester
Universidade Federal de São Paulo (UNIFESP)
PUC
James P Wilmont Canc Ctr
Univ S Florida
Resumo Purpose Current treatment for febrile neutropenia (FN) includes hospitalization for evaluation, empiric broad-spectrum antibiotics, and other supportive care. Clinical trials have reported conflicting results when studying whether the colony-stimulating factors (CSFs) improve outcomes in patients with FN. This Cochrane Collaboration review was undertaken to further evaluate the safety and efficacy of the CSFs in patients with FN.Methods An exhaustive literature search was undertaken including major electronic databases (CANCERLIT, EMBASE, LILACS, MEDLINE, SCI, and the Cochrane Controlled Trials Register). All randomized controlled trials that compare CSFs plus antibiotics versus antibiotics alone for the treatment of established FN in adults and children were sought. A meta-analysis of the selected studies was performed.Results More than 8,000 references were screened, with 13 studies meeting eligibility criteria for inclusion. the overall mortality was not influenced significantly by the use of CSF (odds ratio [OR] = 0.68; 95 % Cl, 0.43 to 1.08; P = .1). A marginally significant result was obtained for the use of CSF in reducing infection-related mortality (OR = 0.51; 95 % Cl, 0.26 to 1.00; P = .05). Patients treated with CSFs had a shorter length of hospitalization (hazard ratio [HR] 0.63; 95 % Cl, 0.49 to 0.82; P = .0006) and a shorter time to neutrophil recovery (HR 0.32; 95 % Cl, 0.23 to 0.46; P < .00001).Conclusion the use of the CSFs in patients with established FN caused by cancer chemotherapy reduces the amount of time spent in hospital and the neutrophil recovery period. the possible influence of the CSFs on infection-related mortality requires further investigation.
Idioma Inglês
Data de publicação 2005-06-20
Publicado em Journal of Clinical Oncology. Alexandria: Amer Soc Clinical Oncology, v. 23, n. 18, p. 4198-4214, 2005.
ISSN 0732-183X (Sherpa/Romeo, fator de impacto)
Publicador Amer Soc Clinical Oncology
Extensão 4198-4214
Fonte http://dx.doi.org/10.1200/JCO.2005.05.645
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000229886700025
Endereço permanente http://repositorio.unifesp.br/handle/11600/28345

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