PEG-rhG-CSF与rhG-CSF预防肿瘤化疗相关中性粒细胞减少的有效性和安全性比较的系统评价和Meta分析OACSTPCD

OBJECTIVE:To compare the efficacy and safety of pegylated recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF)and rhG-CSF in the prevention of chemotherapy-related neutropenia.METHODS:PubMed,Embase,the Cochrane Library,CNKI,Wanfang Data and VIP databases were retrieved to collect randomized controlled trials of PEG-rhG-CSF and rhG-CSF in the prevention of chemotherapy-related neutropenia(intervention measures were PEG-rhG-CSF,control measures were rhG-CSF)until May 2023.Literature screening,information extraction and bias risk assessment were carried out by two researchers independently.Meta-analysis was performed by RevMan 5.3 statistical software.RESULTS:A total of 41 studies were included.Meta-analysis showed that compared with rhG-CSF,PEG-rhG-CSF could significantly reduce the incidence of neutropenia with fever(FN)after chemotherapy(OR=0.64,95%CI=0.51-0.81,P=0.0002)and the incidence of grade Ⅲ/Ⅳ neutropenia(OR=0.49,95%CI=0.35-0.69,P<0.0001),the differences were statistically significant;however,differences in the duration of grade Ⅲ/Ⅳ neutropenia(MD=-0.33,95%CI=-0.68-0.01,P=0.06),the recovery time of neutropenia(MD=-0.11,95%CI=-0.32-0.09,P=0.27),the incidence of bone pain or skeletal muscle pain(OR=0.81,95%CI=0.66-1.00,P=0.05)were not statistically significant.CONCLUSIONS:The efficacy of PEG-rhG-CSF in the prevention of FN and grade Ⅲ/Ⅳ neutropenia after chemotherapy is significantly better than that of rhG-CSF,and PEG-rhG-CSF is feasible as primary prevention.