Objective: This study investigates the relationship between the prophylactic use of granulocyte colony-stimulating factors and clinical efficacy, as well as survival outcomes, in patients with advanced non-small cell lung cancer who develop neutropenia following platinum-based dual-drug chemotherapy combined with immunotherapy.

Methods: A retrospective analysis was conducted on patients diagnosed with advanced non-small cell lung cancer and neutropenia in our department from 2021 to 2023. All patients received chemotherapy combined with immunotherapy. The prevention group was given long-acting granulocyte-stimulating factor for preventive treatment, while the control group did not receive preventive treatment.

Consequence: The results of univariate and multivariate analyses in this study indicate that pathological type, distant metastasis, and prophylactic use of granulocyte-stimulating factor are important influencing factors for Progression-Free Survival (PFS). After receiving chemotherapy combined with immunotherapy, the median PFS in the prevention group was 15.500 months, while that in the control group was 8.000 months (p = 0.010). This reduced the risk of disease progression by 80.3% (p = 0.039), which was statistically significant. Additionally, the median PFS for patients with adenocarcinoma components was 15.000 months, while that for patients with squamous cell carcinoma was 7.500 months (p = 0.020), which was also statistically significant. The median PFS for patients with distant metastasis was 5.000 months, while that for patients without distant metastasis was 14.500 months (p = 0.014), and the risk of disease progression increased by 6.396 times (p = 0.047).

Conclusion: Patients with adenocarcinoma components, those with distant metastasis, and those who benefit from chemotherapy combined with immunotherapy by receiving preventive use of granulocyte-stimulating factor can experience a reduced risk of disease progression. This suggests the necessity of closely monitoring neutrophil levels and taking timely intervention measures during the post-treatment monitoring period.