de Castro Javier, Belda-Iniesta Cristóbal, Isla Dolores, Dómine Manuel, Sánchez Alfredo, Batiste Eduard, Barón Manuel González
Servicio de Oncología Médica, Hospital Universitario La Paz (Madrid), Paseo de la Castellana, 261, 28046 Madrid, Spain.
Lung Cancer. 2008 Feb;59(2):211-8. doi: 10.1016/j.lungcan.2007.08.006. Epub 2007 Sep 17.
The NeoPrevent study showed that early intervention with epoetin beta could prevent severe anaemia in patients with solid tumours receiving platinum-based chemotherapy. An early intervention strategy may be particularly warranted in patients with lung cancer, as anaemia is very common in these patients and can be severe. The purpose of this study was to examine the efficacy and safety of epoetin beta in the subpopulation of patients with lung cancer included in the NeoPrevent study. Patients were enrolled if baseline haemoglobin (Hb) levels were <or=13 g/dl (men) or <or=12 g/dl (women), or fell to these levels during platinum-based chemotherapy. Patients received epoetin beta 150 IU/kg three times weekly, until 4 weeks after last chemotherapy cycle. The anaemia prevention response was measured as the proportion of patients with an Hb response (Hb increase of >1g/dl) plus the proportion whose Hb was maintained at +/-1g/dl of baseline. Quality of life (QoL) was measured using the linear analogue scale assessment. The NeoPrevent study included 255 patients in total, and the results for the 102 patients with lung cancer (non-small-cell lung cancer 64%; small-cell lung cancer 36%) are presented here. The overall anaemia prevention response was 90%, with Hb response in 60% of patients and maintenance of baseline Hb level in 30%. Only 9% of patients required transfusions. QoL improved significantly in patients with Hb response (p<0.01) and was maintained in non-responders (p>or=0.578). Epoetin beta was effective in preventing severe anaemia in lung cancer patients receiving platinum-based chemotherapy.
NeoPrevent研究表明，对接受铂类化疗的实体瘤患者早期使用β-促红细胞生成素可预防严重贫血。早期干预策略对于肺癌患者可能尤为必要，因为贫血在这些患者中非常常见且可能很严重。本研究的目的是在NeoPrevent研究纳入的肺癌患者亚组中检验β-促红细胞生成素的疗效和安全性。如果基线血红蛋白（Hb）水平≤13 g/dl（男性）或≤12 g/dl（女性），或在铂类化疗期间降至这些水平，则纳入患者。患者每周三次接受150 IU/kg的β-促红细胞生成素，直至最后一个化疗周期后4周。贫血预防反应的衡量指标为出现Hb反应（Hb升高>1g/dl）的患者比例加上Hb维持在基线水平±1g/dl的患者比例。使用线性模拟量表评估生活质量（QoL）。NeoPrevent研究共纳入255例患者，本文展示了102例肺癌患者（非小细胞肺癌占64%；小细胞肺癌占36%）的结果。总体贫血预防反应为90%，60%的患者出现Hb反应，30%的患者维持基线Hb水平。仅9%的患者需要输血。出现Hb反应的患者QoL显著改善（p<0.01），无反应者的QoL保持稳定（p≥0.578）。β-促红细胞生成素对接受铂类化疗的肺癌患者预防严重贫血有效。
