Home›ENT (Otolaryngology)› Pegfilgrastim prophylaxis reduces febrile neutropenia in esophageal cancer patients receiving DCF chemotherapy
Pegfilgrastim prophylaxis reduces febrile neutropenia in esophageal cancer patients receiving DCF chemotherapyPegfilgrastim Reduces Serious Risks for Patients with Esophageal Cancer
Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy PractitionersPublished October 8, 2026Study authors: Hemdan Khaled, El Tabakh Rana Mohamed, Elmezayen Ziad W, Yousef Amr Mahmoud, Hussein Ahmed, Elgharea…PubMed ↗DOI ↗Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic
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Key Takeaway
Consider pegfilgrastim prophylaxis for DCF chemotherapy in esophageal cancer to reduce febrile neutropenia.
This meta-analysis synthesized evidence on prophylactic pegfilgrastim in patients with esophageal cancer receiving DCF chemotherapy. The review focused on febrile neutropenia as the primary outcome, with severe neutropenia and hospital stays as secondary outcomes.
The authors report that pegfilgrastim significantly reduces the risk of febrile neutropenia, severe neutropenia, and hospital stays compared with placebo or no G-CSF. No significant increase in adverse events was observed. However, the abstract contains placeholders where specific numerical data were omitted, so effect sizes, absolute numbers, and p-values or confidence intervals were not reported.
The authors note that further prospective randomized trials are needed to optimize dosing strategies and confirm long-term benefits. Funding or conflicts of interest were not reported. The evidence is limited by the lack of quantitative synthesis details and the need for additional randomized data.
In practice, these findings support the routine use of pegfilgrastim in esophageal cancer patients receiving DCF chemotherapy, but clinicians should interpret the magnitude of benefit cautiously given the incomplete reporting of effect estimates.
How this fits prior evidence
This meta-analysis extends prior coverage of cisplatin-based regimens in head and neck and prostate cancers by focusing on esophageal cancer and adding pegfilgrastim prophylaxis to DCF chemotherapy. It aligns with the theme of optimizing supportive care during platinum-based treatment, as seen in prior findings on weekly cisplatin noninferiority and the temporary regression with etoposide plus cisplatin. The reported reductions in febrile neutropenia and hospital stays address a gap in managing DCF toxicity, though the absence of effect sizes limits direct comparison with prior quantitative results.
A review of medical data looked at how the medication pegfilgrastim affects patients with esophageal cancer. These patients were receiving a specific chemotherapy regimen known as DCF. The study compared patients who received pegfilgrastim to those who received a placebo or no G-CSF treatment.
The results showed that pegfilgrastim significantly reduced the risk of febrile neutropenia, which is a dangerous drop in white blood cells that causes fever. It also significantly reduced cases of severe neutropenia and shortened the amount of time patients spent in the hospital. No significant increase in adverse events was reported during the study.
Because this was a meta-analysis, the findings are helpful but need more specific testing to confirm the best ways to give the medicine. While the results support using pegfilgrastim for these patients, more large trials are needed to confirm long-term benefits. You should talk to your doctor about how these findings apply to your specific treatment plan.
What this means for you:
Pegfilgrastim may reduce infection risks and hospital stays for esophageal cancer patients on DCF chemotherapy.
Common questions
What is febrile neutropenia and how does pegfilgrastim help?
Febrile neutropenia is a dangerous condition where a patient has a low white blood cell count and a fever. This study found that using pegfilgrastim significantly reduces the risk of febrile neutropenia in patients with esophageal cancer receiving DCF chemotherapy.
Can pegfilgrastim reduce hospital stays for cancer patients?
Yes, the study results showed that pegfilgrastim significantly reduces hospital stays for patients with esophageal cancer who are undergoing DCF chemotherapy. This suggests it may help patients manage their treatment more effectively.
Is pegfilgrastim safe to use with chemotherapy?
The study reported no significant increase in adverse events for patients taking pegfilgrastim with DCF chemotherapy. However, more trials are still needed to confirm long-term benefits and the best dosing strategies.
BackgroundEsophageal cancer remains a leading cause of cancer-related mortality worldwide, with docetaxel, cisplatin, and fluorouracil (DCF) chemotherapy being a standard treatment option for locally advanced disease. However, DCF is associated with a high incidence of febrile neutropenia (FN), a serious complication that can lead to treatment delays, hospitalizations, and increased morbidity. Pegfilgrastim, a long-acting granulocyte colony-stimulating factor (G-CSF), is recommended for FN prevention, but its efficacy in esophageal cancer patients receiving DCF chemotherapy remains unclear.MethodsA systematic literature search of PubMed, Cochrane Library, Scopus, and Web of Science identified eligible studies. Retrospective and prospective studies comparing prophylactic pegfilgrastim with placebo or no G-CSF in patients undergoing DCF therapy were included. Eight reviewers independently screened studies, extracted data, and assessed quality using the Newcastle-Ottawa Scale. The extracted data were then verified by two additional reviewers. A meta-analysis was conducted to calculate pooled effect sizes.ResultsPooled analysis showed that (OR = , 95% CI: , ). FN rates ranged from in the pegfilgrastim group versus in the control group. Pegfilgrastim was also associated with , with no significant increase in adverse events.ConclusionsIn our study, Pegfilgrastim prophylaxis significantly reduces FN risk, severe neutropenia, and hospital stays in esophageal cancer patients receiving DCF chemotherapy, without increasing major complications. These findings support its routine use in this population, though further prospective randomized trials are needed to optimize dosing strategies and confirm long-term benefits.
