Myeloid growth factors with radiation – pro
Human growth factors are firmly established in treatment of cytopenias that are associated with cancer chemotherapy, and have been used successfully to reduce severe mucositis in patients receiving radiation therapy and chemotherapy in the setting of autologous bone marrow transplantation. The concern in using G-CSF together with radiation is two fold. First, they may protect cancer tissue from radiation damage. Secondly, especially in cancers near major bone marrow production sites, such as lung cancers that are being radiation, they may induce greater neutropenia than expected, and not be protective but actually be harmful. For these reasons, the Prescribing Information for Neulasta and Neupogen state that prophylactic use of CSFs in patients given concurrent chemotherapy and radiation is not recommended.
J. Crawford et al, Myeloid growth factors, J Natl Compr Canc Netw 2011;9:914-932
NCCN, Supportive 2017