Département d’Oncologie Médicale, Centre Léon Bérard, Lyon, France.
Adv Ther. 2012 Feb;29(2):124-33. doi: 10.1007/s12325-011-0093-2.
The purpose of this French survey was to evaluate the adherence to the guidelines (European Organisation for Research and Treatment of Cancer [EORTC]; American Society of Clinical Oncology [ASCO]; French Standards, Options, and Recommendations [SOR]; European Society of Medical Oncology [ESMO]; Food and Drug Administration [FDA]; and National Comprehensive Cancer Network [NCCN]) for the use of erythropoiesis-stimulating agents (ESAs) in the management of chemotherapy- induced anemia for patients with advanced breast and lung cancers.
Two-hundred patients were recruited for each malignancy. The collected items were characteristics of ESA initiation, treatment, adjustment, and discontinuation. Metastatic breast cancer and stage IIIb/IV lung cancer patients who had received chemotherapy were eligible. The endpoint was to compare French daily practices with national and international guidelines.
From November 2010 to December 2010, 185 breast cancer and 227 lung cancer files were collected. The main reason of ESA initiation was the correction of anemia (49% and 44%, respectively). The median baseline value of hemoglobin was 9.5 g/dL, and the median target value was 12 g/dL. The mean duration of treatment was 12 and 14 weeks, respectively. The mean gain of hemoglobin was 2.3 g/dL and 1.9 g/dL, respectively. In the breast cancer population, two patients (1%) developed a thromboembolic event, which is lower than what has been described in the literature. An iron supplement was prescribed in 55% of patients with breast cancer and 49% of those with lung cancer, with about one-third administered intravenous iron. The interruption of ESA and chemotherapy was synchronous in about 20% of cases, and was earlier in lung cancer patients than in breast cancer patients.
The quality and the rigor of the sampling represent one of the key points of this survey. The French and international guidelines for the use of ESA were well respected by the physicians. Overall, the management of chemotherapy-induced anemia was improved compared with what was described in the historical surveys (European Cancer Anaemia Survey [ECAS], French Anaemia Cancer Treatment [F-ACT]).
本项法国调查旨在评估遵循（欧洲癌症研究与治疗组织 [EORTC]；美国临床肿瘤学会 [ASCO]；法国标准、选择和建议 [SOR]；欧洲肿瘤内科学会 [ESMO]；美国食品和药物管理局 [FDA]；和国家综合癌症网络 [NCCN]）指导原则治疗晚期乳腺癌和肺癌患者化疗引起的贫血时的应用（促红细胞生成素刺激剂 [ESA]）。
每类恶性肿瘤招募 200 例患者。收集的项目包括 ESA 起始、治疗、调整和停药的特征。入组标准为接受化疗的转移性乳腺癌和 IIIb/IV 期肺癌患者。终点是比较法国的日常实践与国家和国际指南。
2010 年 11 月至 12 月共收集了 185 例乳腺癌和 227 例肺癌病历。ESA 起始的主要原因是纠正贫血（分别为 49%和 44%）。血红蛋白的基线中位数为 9.5 g/dL，目标中位数为 12 g/dL。治疗的平均持续时间分别为 12 和 14 周。血红蛋白的平均增加量分别为 2.3 g/dL 和 1.9 g/dL。在乳腺癌患者中，有 2 例（1%）发生血栓栓塞事件，低于文献描述的水平。55%的乳腺癌患者和 49%的肺癌患者开具了铁补充剂，约三分之一给予了静脉铁。ESA 和化疗的中断在约 20%的病例中是同步的，在肺癌患者中比在乳腺癌患者中更早。
该调查的关键点之一是采样的质量和严格性。法国和国际 ESA 应用指南得到了医生的尊重。总体而言，与历史调查（欧洲癌症贫血调查 [ECAS]，法国贫血癌症治疗 [F-ACT]）相比，化疗引起的贫血的治疗得到了改善。
