Iconomou G, Koutras A, Karaivazoglou K, Kalliolias G D, Assimakopoulos K, Argyriou A A, Ifanti A, Kalofonos H P
Division of Oncology, Department of Medicine, University of Patras Medical School, Greece.
Eur J Cancer Care (Engl). 2008 Nov;17(6):535-41. doi: 10.1111/j.1365-2354.2007.00857.x. Epub 2008 Aug 13.
The primary aim of this study was to assess whether epoetin alpha (Ea) would improve cognitive performance in a group of anaemic cancer patients receiving chemotherapy. The secondary aim was to confirm the positive impact of Ea on haematological parameters, and quality of life (QOL). Fifty patients with solid tumours and haemoglobin (Hb) <11.0 g/dL received Ea 40,000 units once weekly for 12 weeks and were administered the Mini-Mental State Examination and the European Organization for Research and Treatment of Cancer (QLQ-C30) questionnaire prior to Ea therapy and at study completion. No clinically significant alterations were observed on cognitive function during Ea treatment. Changes in cognitive function were unrelated to Hb change and there were no significant differences in cognitive performance between Ea responders and non-responders. The analyses revealed clinically significant improvements in Hb levels, physical and role function, and clinically meaningful reductions in fatigue. Hb changes were significantly associated with the magnitude of improvement in QOL parameters. The lack of a clinical benefit in cognition observed in this study during Ea treatment may redirect the focus of research from enhancing to maintaining cognitive function, since stability in cognitive performance through time may be as well clinically important.
本研究的主要目的是评估促红细胞生成素α(Ea)是否能改善一组接受化疗的贫血癌症患者的认知表现。次要目的是确认Ea对血液学参数和生活质量(QOL)的积极影响。50例实体瘤患者且血红蛋白(Hb)<11.0 g/dL,每周一次接受40,000单位Ea治疗,共12周,并在Ea治疗前和研究结束时接受简易精神状态检查以及欧洲癌症研究与治疗组织(QLQ-C30)问卷。在Ea治疗期间,未观察到认知功能有临床显著改变。认知功能的变化与Hb变化无关,Ea反应者和无反应者在认知表现上无显著差异。分析显示Hb水平、身体和角色功能有临床显著改善,疲劳有临床意义的减轻。Hb变化与QOL参数改善程度显著相关。本研究中在Ea治疗期间未观察到对认知的临床益处,这可能会将研究重点从增强认知功能转向维持认知功能,因为认知表现随时间的稳定性在临床上可能同样重要。