Geiser Franziska, Hahn Corinna, Conrad Rupert, Liedtke Reinhard, Sauerbruch Tilman, Schmidt-Wolf Ingo, Glasmacher Axel
Clinic for Psychosomatics, University of Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany.
Support Care Cancer. 2007 Mar;15(3):273-8. doi: 10.1007/s00520-006-0132-8. Epub 2006 Aug 25.
Epoetin alpha is known to produce a hematological response in anemic cancer patients. A concomitant reduction in fatigue as well as an improvement of depression and anxiety and of quality of life has been reported. However, these effects are discussed controversially. Psychological variables may have a moderating effect on fatigue reduction.
Fifty-four anemic cancer outpatients were treated with epoetin alpha over 26 weeks with an initial dose of 3 x 10,000 IU/week and further individually adapted dosage. Hemoglobin level, fatigue, depression, anxiety, and health-related quality of life were measured every 4 weeks.
The hematological response rate was 50%, with 1/3 occurring after more than 8 weeks of treatment. Fatigue, depression, and quality of life improved significantly. Reduction in fatigue was associated with response, but the correlations between fatigue and hemoglobin were weak. Less depression and higher quality of life before treatment correlated with a better fatigue reduction when controlling for hemoglobin increase and initial fatigue level.
Psychological variables influence the reduction of fatigue during therapy with epoetin alpha in anemic cancer patients and should therefore be assessed at the beginning of treatment.
已知促红细胞生成素α可使贫血癌症患者产生血液学反应。据报道,同时还能减轻疲劳,并改善抑郁、焦虑症状及生活质量。然而,这些效果存在争议。心理变量可能对减轻疲劳有调节作用。
54例贫血癌症门诊患者接受促红细胞生成素α治疗26周,初始剂量为每周3×10,000国际单位,后续剂量根据个体情况调整。每4周测量血红蛋白水平、疲劳程度、抑郁、焦虑及与健康相关的生活质量。
血液学反应率为50%,其中1/3在治疗8周后出现。疲劳、抑郁及生活质量均有显著改善。疲劳减轻与反应相关,但疲劳与血红蛋白之间的相关性较弱。在控制血红蛋白增加量和初始疲劳水平后,治疗前抑郁程度较低及生活质量较高与疲劳减轻效果较好相关。
心理变量会影响贫血癌症患者使用促红细胞生成素α治疗期间的疲劳减轻情况,因此在治疗开始时应进行评估。