Nowrousian Mohammad R, Dunst Jürgen, Vaupel Peter
Department of Internal Medicine Cancer Research, West-German Cancer Center, University Hospital Essen, Germany.
Strahlenther Onkol. 2008 Mar;184(3):121-36. doi: 10.1007/s00066-008-1841-3.
Several studies with erythropoiesis-stimulating agents (ESAs) have raised a number of safety issues. Therefore, a discussion of available data in light of the current EORTC guidelines 2006 on the use of ESAs in anemic patients is warranted.
Literature is reviewed with respect to experimental and clinical data on the effect of ESA therapy on tumor growth both in the preclinical setting and on patient survival.
Studies showing an adverse effect of ESA therapy on patient survival generally exhibit considerable methodological deficiencies. Moreover, they investigated treatment situations for which ESAs are not approved and/or did not involve recommended baseline ("intervention") or target hemoglobin levels.
When used as indicated, ESAs are valuable and safe drugs for the treatment of anemia and do not negatively affect patient survival. In particular, the data situation confirms the importance and correctness of the EORTC guidelines 2006 and their recently updated version. It is therefore recommended that these guidelines continue to be strictly followed in the treatment of chemotherapy-induced anemia.
多项关于促红细胞生成素（ESAs）的研究引发了诸多安全问题。因此，有必要根据2006年欧洲癌症研究与治疗组织（EORTC）关于在贫血患者中使用ESAs的现行指南来讨论现有数据。
回顾关于ESA治疗在临床前环境以及患者生存方面对肿瘤生长影响的实验和临床数据的文献。
显示ESA治疗对患者生存有不良影响的研究通常存在相当大的方法学缺陷。此外，这些研究调查的治疗情况是ESAs未被批准的，和/或未涉及推荐的基线（“干预”）或目标血红蛋白水平。
按指示使用时，ESAs是治疗贫血的有价值且安全的药物，不会对患者生存产生负面影响。特别是，数据情况证实了2006年EORTC指南及其最近更新版本的重要性和正确性。因此，建议在治疗化疗引起的贫血时继续严格遵循这些指南。
