Marchetti C, De Felice F, Palaia I, Musio D, Muzii L, Tombolini V, Benedetti Panici P
Department of Gynecological and Obstetrical Sciences and Urological Sciences, "Sapienza" University of Rome, Viale Regina Elena 326, Rome 00161 Italy.
Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Viale Regina Elena 326, Rome 00161, Italy.
Crit Rev Oncol Hematol. 2016 Mar;99:123-8. doi: 10.1016/j.critrevonc.2015.12.013. Epub 2015 Dec 29.
This meta-analysis was planned to define the role of erythropoiesis-stimulating agents (ESAs) in gynecological cancer patients, receiving myelosuppressive treatment. Pubmed, Medline and Scopus were searched to select English-language articles. Only randomized controlled trials (RCTs) were included. Endpoints were incidence of transfusions, thrombotic events (TE), deaths, and failures. Odd ratio (OR) with 95% confidence interval (CI) was calculated using fixed or random effects model. In seven RCTs ESAs studies of 892 patients under treatment, use of ESAs correlates with a significant reduction of transfusions rate (OR=0.35; 95% CI: 0.19-0.65; p=0.008). OR for overall mortality was 1.10 (95% CI 0.82-1.49; p=0.53). ESAs OR for disease failure in 5 studies was 1.71 (95% CI: 0.90-3.24; p=0.1). This meta-analysis, even if limited by few RCTs, suggests that ESAs reduce transfusions without increasing mortality or disease progression in gynecological cancer patients receiving treatment.
本荟萃分析旨在确定促红细胞生成素（ESA）在接受骨髓抑制治疗的妇科癌症患者中的作用。检索了PubMed、Medline和Scopus以筛选英文文章。仅纳入随机对照试验（RCT）。观察终点为输血发生率、血栓事件（TE）、死亡和治疗失败。使用固定或随机效应模型计算比值比（OR）及95%置信区间（CI）。在7项RCT中，对892例接受治疗患者的ESA研究显示，使用ESA与输血率显著降低相关（OR=0.35；95%CI：0.19-0.65；p=0.008）。总死亡率的OR为1.10（95%CI 0.82-1.49；p=0.53）。5项研究中ESA治疗失败的OR为1.71（95%CI：0.90-3.24；p=0.1）。本荟萃分析虽受限于少量RCT，但提示ESA可减少输血，且不增加接受治疗的妇科癌症患者的死亡率或疾病进展。
