α-促红细胞生成素用于局部晚期食管胃腺癌新辅助化疗期间

Erythropoietin-alfa during neoadjuvant chemotherapy for locally advanced esophagogastric adenocarcinoma.

作者信息

Abbrederis Kathrin, Bassermann Florian, Schuhmacher Christoph, Voelter Verena, Busch Raymonde, Roethling Nadine, Sendler Andreas, Siewert Joerg R, Peschel Christian, Lordick Florian

机构信息

Third Department of Medicine (Hematology/Oncology), Institute for Medical Statistics and Epidemiology, and Munich Center for Clinical Studies, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

出版信息

Ann Thorac Surg. 2006 Jul;82(1):293-7. doi: 10.1016/j.athoracsur.2006.01.097.

DOI:10.1016/j.athoracsur.2006.01.097

PMID:16798232

Abstract

BACKGROUND

In a previous study we showed that many patients with esophagogastric adenocarcinoma experience anemia during neoadjuvant chemotherapy. We now investigated the role of erythropoietin in managing anemia during neoadjuvant chemotherapy.

METHODS

Patients with esophagogastric adenocarcinoma who experienced anemia (hemoglobin < 12 g/dL) during neoadjuvant treatment received erythropoietin 10,000 IE subcutaneously three times a week. Primary outcomes were the response to erythropoietin, safety, the need for allogeneic red blood cell transfusion, and the rate of postoperative complications.

RESULTS

Between April 2003 and December 2004, 24 patients (median age, 62 years) were enrolled. The mean hemoglobin level before chemotherapy was 12.5 g/dL and the mean hemoglobin level before patients received erythropoietin was 11.5 g/dL. One year after involvement in the trial, 4 of 17 analyzable patients were still anemic (hemoglobin level < 12 mg/dL). Twenty-two patients received erythropoietin, and 16 (73%) responded. We could observe a significant increase in hemoglobin concentrations under therapy with erythropoietin to 12.6 g/dL (p < 0.001). Two patients (8%) received allogeneic transfusions; the rate of postoperative complications was 16%. There were no erythropoietin-related adverse events.

CONCLUSIONS

Treatment with erythropoietin is effective and well tolerated in patients with esophagogastric adenocarcinoma who experience anemia during neoadjuvant chemotherapy.

摘要

背景

在之前的一项研究中，我们发现许多食管胃腺癌患者在新辅助化疗期间会出现贫血。我们现在研究了促红细胞生成素在新辅助化疗期间治疗贫血中的作用。

方法

在新辅助治疗期间出现贫血（血红蛋白<12 g/dL）的食管胃腺癌患者，每周皮下注射促红细胞生成素10,000国际单位，共三次。主要结局包括对促红细胞生成素的反应、安全性、异体红细胞输血需求及术后并发症发生率。

结果

2003年4月至2004年12月，共纳入24例患者（中位年龄62岁）。化疗前平均血红蛋白水平为12.5 g/dL，患者接受促红细胞生成素治疗前平均血红蛋白水平为11.5 g/dL。参与试验一年后，17例可分析患者中有4例仍贫血（血红蛋白水平<12 mg/dL）。22例患者接受了促红细胞生成素治疗，其中16例（73%）有反应。我们观察到促红细胞生成素治疗期间血红蛋白浓度显著升高至12.6 g/dL（p<0.001）。2例患者（8%）接受了异体输血；术后并发症发生率为16%。未发生与促红细胞生成素相关的不良事件。