Granulocyte colony stimulating factor for prevention of craniospinal radiation treatment interruption among central...

In this pilot randomized clinical trial the preventive effects of weekly granulocyte colony stimulating factor (GCSF) injection for patients with central nervous system (CNS) tumors receiving craniospinal irradiation were assessed with regard to risk of treatment interruption.

We randomized 40 CNS cancer patients into two groups (20 patients each), the first receiving GCSF prevention therapy before weekly craniospinal radiotherapy and the control group without this prophylaxis. The main outcome was whether GCSF preventive therapy decreased the rate of interruption of radiotherapy because of leucopenia and thrombocytopenia. We used t -test, and chi-square test statistics to compare the quantitative and qualitative outcomes.

there were no significant differences in platelets and WBC loss between the treatment and control groups. Treatment interruption was lower in weekly GCSF therapy group (35%), compared to the control group (55%), although the difference was not statistically significant (P value 0.2). While 8 patients (40%) also received GCSF therapy due to leucopenia in the control group only one patient reached a critical level and needed GCSF therapy because of irradiation complications (p-value 0.02). Among those who received naodjuvant chemotherapy (8 patients in each group), among the GCSF prevention group only in one (12%) we had to interrupt radiotherapy, as compared to 6 in the control group due to WBC loss.

Weekly GSCF injections among CNS tumor patients receiving craniospinal therapy may decrease treatment interruption. A larger study with longer follow-up is now needed to confirm our results.