Cartenì Giacomo, Giannetta Laura, Ucci Giovanni, De Signoribus Giorgio, Vecchione Aldo, Pinotti Graziella, Puglisi Fabio, Contillo Antonio, Pezzella Giuseppe, Orecchia Simona, Beccaglia Patrizia
Department of Medical Oncology, Cardarelli Hospital, Via Cardarelli, 9, 80131 Napoli, Italy.
Support Care Cancer. 2007 Sep;15(9):1057-66. doi: 10.1007/s00520-007-0220-4. Epub 2007 Apr 13.
Anemia is frequently associated with cancer due to the disease itself and antineoplastic treatments. This open-label, uncontrolled, multi-center study evaluated the effects of once-weekly (qw) epoetin alfa 40,000 IU on hemoglobin (Hb) levels and quality of life (QoL) in anemic patients receiving chemotherapy for solid tumors.
A total of 522 patients with Hb level < or =12 g/dL received epoetin alfa 40,000 IU qw subcutaneously for 9-20 weeks to reach and maintain Hb range of 12-14 g/dL. QoL was assessed with the Functional Assessment of Cancer Therapy-Anemia (FACT-An [anemia sub-scale]) and Cancer Linear Analogue Scale (CLAS) at study entry, after two chemotherapy cycles, and at study end.
Mean baseline Hb was 10.43 g/dL. Hb increases (g/dL) from baseline after 4, 8, 12 weeks and at study end were 1.07, 1.77, 1.92 and 1.71 g/dL, respectively. Response rates (Hb increase > or =1 and > or =2 g/dL during trial) were 81% and 61%, respectively. Mean increases in the FACT-An score from baseline (mean 55.4) were 3.1 after two chemotherapy cycles and 3.3 at study end; mean increases in the CLAS score from baseline (58.4 mm) were 5.9 mm after two chemotherapy cycles and 6.5 mm at study end.
The greatest QoL increase was recorded when patients approached Hb level of 12 g/dL, independent of the baseline Hb level. Hb changes from baseline to trial end were related to corresponding changes in the FACT-An score. A positive correlation was also observed in patients with progressive disease. Adverse events were essentially those associated with chemotherapy. Incidence of thrombovascular events (6.7%) did not differ from the expected standard treatment in cancer patients. Epoetin alfa 40,000 IU qw increased Hb levels and improved or preserved QoL.
由于疾病本身及抗肿瘤治疗,贫血常与癌症相关。本开放性、非对照、多中心研究评估了每周一次皮下注射40,000国际单位促红细胞生成素α对实体瘤化疗贫血患者血红蛋白(Hb)水平及生活质量(QoL)的影响。
共522例Hb水平≤12 g/dL的患者接受每周一次皮下注射40,000国际单位促红细胞生成素α,持续9 - 20周,以使Hb达到并维持在12 - 14 g/dL范围。在研究开始时、两个化疗周期后及研究结束时,采用癌症治疗贫血功能评估量表(FACT - An[贫血子量表])和癌症线性模拟量表(CLAS)评估生活质量。
平均基线Hb为10.43 g/dL。4周、8周、12周及研究结束时Hb较基线的增加值(g/dL)分别为1.07、1.77、1.92和1.71 g/dL。缓解率(试验期间Hb增加值≥... )分别为81%和61%。两个化疗周期后及研究结束时,FACT - An评分较基线(平均55.4)的平均增加值分别为3.1和3.3;CLAS评分较基线(58.4 mm)的平均增加值在两个化疗周期后为5.9 mm,研究结束时为6.5 mm。
当患者Hb水平接近12 g/dL时,生活质量改善最为显著,与基线Hb水平无关。从基线到试验结束时Hb的变化与FACT - An评分的相应变化相关。在疾病进展患者中也观察到正相关。不良事件主要为与化疗相关的事件。血栓血管事件发生率(6.7%)与癌症患者预期的标准治疗无差异。每周一次40,000国际单位促红细胞生成素α可提高Hb水平并改善或维持生活质量。