Transdermal Oestradiol in the Management of Castration-resistant and Corticosteroid-resistant Prostate Cancer — a Dose Escalation Study

Abstract

s / Clinical Oncology 25 (2013) e67ee74 e72 [1]. Prophylactic use of granulopoiesis-stimulating factors, such as granulocyte-colony-stimulating factor (G-CSF), is being increasingly used to prevent chemotherapy-induced neutropaenia [2e4]. To compare the rate of febrile neutropaenia before and after implementation of G-CSF prophylaxis in patients receiving chemotherapy for testicular cancer. To determine the impact of these events on unscheduled care. Materials andmethods: Over an 18month period, we prospectively audited the incidence of febrile neutropaenia before (n 1⁄4 12) and after (n 1⁄4 8) implementation of prophylactic pegylated G-CSF (6mg SC 24 h post-chemotherapy) in patients receiving comparable chemotherapy regimens. Identification of febrile neutropaenic episodes and resultant impact on treatment recorded. There were no significant differences in chemotherapy regimens or other supportive care apart from the use of G-CSF. Results: The rate of neutropaenic sepsis was significantly different between the pre-GCSF and post-GCSF group (42% versus 0%, P 1⁄4 0.05). In the pre-GCSF group, 4 patients developing febrile neutropaenia went on to have G-CSF with subsequent cycles. Those developing febrile neutropaenia in the preGCSF group had a cumulative 31 days of unscheduled inpatient stay. This included one patient admitted to intensive care. There were no unscheduled inpatient stays in the post-GCSF group. Conclusion: Use of prophylactic G-CSF following chemotherapy for testicular cancer significantly reduces the incidence of febrile neutropaenia and subsequent inpatient stays.