{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T18:45:55Z","timestamp":1791744355809,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Platinum\u2010doublet concurrent chemoradiotherapy (CCRT) for locally advanced cervical cancer (LACC) is frequently complicated by severe neutropenia. This Phase II trial investigated whether combining active bone marrow\u2010sparing (ABMS) radiotherapy with prophylactic pegylated recombinant human granulocyte colony\u2010stimulating factor (PEG\u2010rhG\u2010CSF) could reduce the incidence of grade \u2265\u20093 neutropenia below a prespecified historical benchmark of 30%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients with FIGO 2018 stage IIA2\u2013IVA LACC received SPECT\u2010guided ABMS radiotherapy (45\u2009Gy external beam plus 30\u2009Gy brachytherapy) concurrent with paclitaxel\/carboplatin every 21\u2009days for 4\u2009cycles followed by prophylactic PEG\u2010rhG\u2010CSF. Using Simon's two\u2010stage design (\n                      <jats:italic>\u03b1<\/jats:italic>\n                      \u2009=\u20090.05,\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.20), we tested whether grade \u2265\u20093 neutropenia could be reduced from a historical benchmark of 30% to \u2264\u200915%. The primary endpoint was grade \u2265\u20093 neutropenia incidence; secondary endpoints included other cytopenias, treatment completion, and survival outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010four patients were enrolled. Grade \u2265\u20093 neutropenia occurred in 13.0% (7\/54; 95% CI: 5.4%\u201324.9%), meeting the prespecified success criterion (one\u2010sided exact binomial test,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003 versus the 30% benchmark). Other grade \u2265\u20093 toxicities included leukopenia (18.5%), anemia (3.7%), thrombocytopenia (5.6%), and febrile neutropenia (1.9%). Overall, 85.2% of patients completed all 4 planned chemotherapy cycles, and all completed radiotherapy within 8\u2009weeks (median overall treatment time: 50\u2009days). At a median follow\u2010up of 40\u2009months, the 3\u2010year progression\u2010free survival (PFS) and overall survival (OS) rates were 88.8% and 88.9%, respectively (6 events each); the study was not powered for survival efficacy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The combination of ABMS radiotherapy and prophylactic PEG\u2010rhG\u2010CSF was associated with a grade \u2265\u20093 neutropenia rate of 13.0% and a chemotherapy completion rate of 85.2% during platinum\u2010doublet CCRT for LACC. Because the single\u2010arm design and reliance on historical controls preclude causal inference, these findings are hypothesis\u2010generating and primarily establish the operational feasibility of this dual hematoprotection approach. Formal evaluation of safety and efficacy requires the ongoing randomized trial (ChiCTR2400087321).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>Chinese Clinical Trial Registry, ChiCTR2100046911. Registered May 30, 2021<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72366","type":"journal-article","created":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:54:35Z","timestamp":1791741275000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined Active Bone Marrow\u2010Sparing Radiotherapy and Prophylactic\n                    <scp>PEG<\/scp>\n                    \u2010\n                    <scp>rhG<\/scp>\n                    \u2010\n                    <scp>CSF<\/scp>\n                    to Reduce Severe Neutropenia During Platinum\u2010Doublet Concurrent Chemoradiotherapy for Locally Advanced Cervical Cancer: A Phase\n                    <scp>II<\/scp>\n                    Trial"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5897-6829","authenticated-orcid":false,"given":"ShanBing","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Oncology The Second People's Hospital of Yibin City  Yibin Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiapei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine The Second People's Hospital of Yibin City  Yibin Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Oncology The Second People's Hospital of Yibin City  Yibin Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaijian","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Oncology The Second People's Hospital of Yibin City  Yibin Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxiu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Oncology The Second People's Hospital of Yibin City  Yibin Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology The Second People's Hospital of Yibin City  Yibin Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Oncology The Second People's Hospital of Yibin City  Yibin Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuming","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Oncology The Second People's Hospital of Yibin City  Yibin Sichuan 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Prophylaxis Treatment With PEG\u2010rhG\u2010CSF for Cervical Cancer Patients Improves the Neutropenia and Life Quality of Patients: A Cohort Study","volume":"41","author":"Mei Z.","year":"2020","journal-title":"Medical Journal of Wuhan University"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010024\u201012556\u20104"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.2601"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16101842"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34771"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2011.01.020"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2021.01.025"},{"key":"e_1_2_12_25_1","volume-title":"NCCN Clinical Practice Guidelines in Oncology: Hematopoietic Growth Factors","author":"NCCN Guidelines Panel 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