Mapping supportive-care evidence for febrile neutropenia prevention in breast cancer chemotherapy: a bibliometric analysis of long-acting G-CSF prophylaxis.

Abstract

Chemotherapy-induced neutropenia and febrile neutropenia (FN) remain consequential toxicities in breast cancer treatment, driving infections, unplanned care, and compromises in planned dose intensity. Long-acting granulocyte colony-stimulating factor (G-CSF) enables once-per-cycle prophylaxis and has become central to FN prevention strategies, particularly in dose-dense and high-risk regimens. Beyond efficacy, the supportive care evidence base has rapidly expanded to implementation in routine practice, delivery devices, biosimilars, safety surveillance, and value-based decision-making. However, this heterogeneous and fast-growing literature has not been systematically mapped to support evidence navigation and identify actionable research priorities. We therefore conducted a bibliometric analysis to characterize the knowledge structure, influential contributors, and emerging hotspots of long-acting G-CSF prophylaxis research in breast cancer chemotherapy. Publications were retrieved from the Science Citation Index Expanded of the Web of Science Core Collection using a topic strategy combining breast cancer, chemotherapy-induced context, long-acting G-CSF agents, and neutropenia/FN prophylaxis concepts. The search was performed on 24 February 2026 and covered 2002-2025. English-language records were included; document types were limited to articles and reviews, with meeting abstracts, editorial materials, and letters excluded during screening. Bibliometrix, VOSviewer, and CiteSpace were applied to evaluate annual production, collaboration networks, keyword co-occurrence, co-citation structure and evolution, burst detection, and thematic mapping. The WoSCC retrieval returned 555 records; after restricting to English (547) and excluding meeting abstracts (n = 39), editorial materials (n = 5), and letters (n = 7), 496 publications were included (412 articles; 84 reviews). Annual production increased and entered a sustained high-output phase in the late 2010s and early 2020s. The USA was the most productive country (218 documents; 10,188 citations), followed by Germany (69) and England (51). Supportive Care in Cancer contributed the most publications (62), while Annals of Oncology had the highest citations among the top journals (1489). Co-citation and keyword analyses indicated an evolution from early trial- and guideline-driven supportive care toward optimization in routine practice, real-world prophylaxis evaluation, biosimilars, safety, and cost-effectiveness. The evidence landscape of long-acting G-CSF prophylaxis in breast cancer chemotherapy has evolved from efficacy confirmation toward implementation-oriented supportive care. Current research increasingly emphasizes real-world effectiveness, safety monitoring, biosimilar integration, delivery models, and value-based considerations. By mapping knowledge structures and emerging priorities, this study may provide a structured overview for evidence navigation and may help identify future research priorities, particularly in relation to real-world utilization, affordability, guideline-concordant use, and resource-sensitive febrile neutropenia prevention.