Effect of prophylactic PEGylated granulocyte colony-stimulating factor administration on T lymphocyte subsets in patients with gastric cancer
ZHANG Juping
KONG Qian
ZHANG Jibo
CHEN Jie
GUO Jun
Abstract：Objective To explore the impact of prophylactic use of polyethylene glycolated(PEGylated)recombi-nant human granulocyte colony-stimulating factor(G-CSF)combined with capecitabine-containing chemotherapy regimens on T lymphocyte subsets and safety in patients with gastric cancer.Methods A total of 100 patients with gastric cancer admitted to Xingtai People's Hospital from April 2022 to December 2024 were prospectively included and randomly divided into the conventional group and the experimental group according to the random number table method,with 50 cases in each group.The conventional group was treated with a chemotherapy regimen containing capecitabine,with recombinant human G-CSF admin-istered upon occurrence of neutropenia during treatment.The experimental group adopted a chemotherapy regimen containing capecitabine,followed by subcutaneous injection of PEGylated recombinant human G-CSF 24 hours after each chemotherapy cycle to provide prophylactic therapy.One cycle was 21 days.Both patients in the conventional group and the experimental group received treatment for 6 cycles.The therapeutic effects after 6 cycles of treatment,the changes in T lymphocyte subsets and quality of life before and after 6 cycles of treatment,as well as the occurrence of neutropenia and adverse reactions during the 6-cycle treatment process were compared between the conventional group and the experimental group.Results After 6 cycles of treatment,the total effective rate of patients in the experimental group was 82.00%(41/50),and that of patients in the conventional group was 74.00%(37/50).There was no statistically significant difference(χ2=0.932,P>0.05).After 6 cy-cles of treatment,the levels of CD4+and CD4+/CD8+in the experimental group and the conventional group((32.81±2.16)%,(1.15±0.16)vs(30.42±2.23)%,(1.02±0.19),respectively)were lower than those before treatment((34.85±2.14)%,(1.33±0.15)(35.16±2.26)%,(1.36±0.12),respectively),and the differences were statistically significant(t=4.744,5.803,10.557,10.698,all P<0.05).And the levels of the above indicators in the experimental group were higher than those in the conventional group(t=5.443,3.701,both P<0.05).After 6 cycles of treatment,the CD8+levels in the experimental group and the conventional group((28.41±2.44)%and(29.73±2.12)%,respectively)were higher than those before treatment((26.12±2.15)%and(25.94±2.16)%,respectively),and the differences were statistically significant(t=4.979,8.855,both P<0.05).The level in the experimental group was lower than that in the conventional group,and the difference was statistically significant(t=2.888,P<0.05).After 6 cycles of treatment,the incidence of neutropenia in the experimental group was 10.00%(5/50),lower than that in the conventional group(32.00%(16/50)),and the difference was statistically significant(χ2=7.294,P<0.05).After 6 cycles of treatment,the scores of functional domain,symptom domain,single-item questions,and overall health status in the experimental group((85.42±4.23)points,(64.71±6.44)points,(74.37±6.26)points and(74.11±6.17)points,respectively)were higher than those in the convention-al group((76.81±5.16)points,(59.73±6.12)points,(67.10±5.29)points and(63.00±6.96)points,respectively),and the differ-ences were statistically significant(t=9.125,3.964,6.272,8.446,all P<0.05).During the 6-cycle treatment period,the incidence of adverse reactions in the experimental group was 12.00%(6/50),and that in the conventional group was 16.00%(8/50),with no statistically significant difference(χ2=0.332,P>0.05).Conclusion The prophylactic use of PEGylated recombinant human G-CSF combined with capecitabine-based chemotherapy regimen demonstrates comparable efficacy to conventional therapy in gastric cancer treatment.Moreover,it can regulate the balance of T lymphocyte subsets,reduce the risk of neutropenia,improve quality of life,and exhibit favorable safety profiles.
Keywords：gastric cancerPEGylated recombinant human granulocyte colony-stimulating factorcapecitabineT lym-phocyte subsetsneutropeniaquality of lifesafety
Publication Date：2025-10-25
Online Publishing Date：2025-11-03(First online date of this platform, not the publication date of the document)
Pages：6( 1253-1258 )