Do you typically recommend avoiding neupogen during radiation treatments?
Answer from: Radiation Oncologist at Community Practice
It depends on the reason and expected benefit.
If myelosuppression is holding up RT for cervical cancer patients, then I would not hesitate to give neupogen to avoid or minimize a treatment break. There would be more benefit to neupogen and continuing RT than a downside. Usually, I would try to giv...
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Radiation Oncologist at Trihealth Cancer Institute I was curious if you or your colleagues had any in...
Answer from: Radiation Oncologist at Academic Institution
Generally speaking, it is our institutional practice to not hold RT for neupogen/neulasta administration. The only times we would consider is if the patient has a concurrent neutropenic fever.
The history behind holding RT during neupogen administration originated in the era of 3D techniques....
Answer from: Radiation Oncologist at Academic Institution
This myth that growth factors cannot be safely combined with RT was tested in the 2D era by a protocol done at the JCRT adding etanidazole to chemoradiotherapy for patients with esophageal cancer. We gave patients G-CSF during the weeks they did not receive chemotherapy. This was effective in keepin...
Answer from: Medical Oncologist at Academic Institution
I am still reluctant to add growth factor support during thoracic radiation. Dr. Lilenbaum published in the Journal of Thoracic Oncology in 2010 a phase II trial incorporating colony-stimulating factors to platinum etoposide thoracic radiation with consolidation docetaxel. 26% of patients had grade ...
Answer from: Radiation Oncologist at Community Practice
To revive an old question! Has anyone's practice changed since the publication of the subset analysis evaluating the use of G-CSF in the phase 3 CONVERT trial (Gomes et al., PMID 33545577)? There appeared to be no difference in radiation-related toxicity, mortality, or survival whether or not patien...
Answer from: Radiation Oncologist at Academic Institution
I agree that we don't hold RT if the patient has been given Neupogen/Neulasta but I encourage the medical oncologists not to give it for the reasons given by @Elizabeth M. Nichols. When the neutrophil count falls below 500, I will recheck the WBC in 2-3 days and continue radiation as long as the neu...
I was curious if you or your colleagues had any in...