Wilkinson P M, Antonopoulos M, Lahousen M, Lind M, Kosmidis P
Christie Hospital, Wilmslow Road, Manchester M20 4BX, UK.
Br J Cancer. 2006 Apr 10;94(7):947-54. doi: 10.1038/sj.bjc.6603004.
This multicentre, open-label, controlled clinical trial assessed the effects of epoetin alfa treatment on haematologic and quality of life (QOL) parameters in 182 anaemic (Hb< or = 12 g dl(-1)) ovarian cancer patients receiving platinum chemotherapy. Patients were randomised 2 : 1 to receive epoetin alfa 10,000-20 000 IU three times weekly plus best standard treatment (BST) or BST only. Main study end points were changes from baseline in haemoglobin (Hb) level, transfusion requirements, and QOL. For the epoetin alfa group, mean Hb increased by 1.8 g dl(-1) by weeks 4-6 and was significantly increased from baseline through study end (P<0.001). The mean change in Hb from baseline was significantly (P<0.001) greater for epoetin alfa than BST patients at all post-baseline evaluations. Significantly fewer epoetin alfa than BST patients required transfusion(s) after the first 4 weeks of treatment (7.9 vs 30.5%; P<0.001). Also, significant (P< or = 0.04) differences favouring the epoetin alfa group over the BST group were found for all three median CLAS scores (Energy Level, Ability to Do Daily Activities, Overall QOL) and the median average CLAS score during chemotherapy. These findings support use of epoetin alfa to increase Hb levels, reduce transfusion use, and improve QOL in anaemic ovarian cancer patients receiving platinum chemotherapy.
这项多中心、开放标签、对照临床试验评估了促红细胞生成素α治疗对182例接受铂类化疗的贫血(血红蛋白≤12 g/dl)卵巢癌患者血液学指标及生活质量(QOL)参数的影响。患者按2:1随机分组,分别接受每周三次、每次10000 - 20000 IU的促红细胞生成素α联合最佳标准治疗(BST),或仅接受BST。主要研究终点为血红蛋白(Hb)水平、输血需求及QOL自基线的变化。对于促红细胞生成素α组,在第4至6周时平均Hb升高了1.8 g/dl,且从基线至研究结束时均显著升高(P<0.001)。在所有基线后评估中,促红细胞生成素α组Hb自基线的平均变化显著大于BST组患者(P<0.001)。治疗4周后,促红细胞生成素α组需要输血的患者明显少于BST组(7.9% 对30.5%;P<0.001)。此外,在化疗期间,促红细胞生成素α组在所有三个CLAS中位数评分(能量水平、日常活动能力、总体QOL)及CLAS平均中位数评分方面均显著优于BST组(P≤0.04)。这些研究结果支持在接受铂类化疗的贫血卵巢癌患者中使用促红细胞生成素α来提高Hb水平、减少输血并改善QOL。