Zhao Feng, Wang Yijuan, Liu Lin, Bian Meiling
Department of Blood Transfusion Medicine, Linzi District People's Hospital, Binzhou Medical University, Zibo, Shandong 255400, P.R. China.
Medical Intensive Care Unit, PKU Care Luzhong Hospital, Zibo, Shandong 255400, P.R. China.
Mol Clin Oncol. 2017 Jun;6(6):925-930. doi: 10.3892/mco.2017.1254. Epub 2017 May 8.
The present study aimed to evaluate the effectiveness of erythropoietin (EPO) for improving cancer-associated malignant anemia. A search was performed for randomized clinical trials, conducted according to the Cochrane manual, using electronic databases including PubMed, EMBASE, the Cochrane Library and ClinicalTrails.gov up to 15 August 2015. A total of 6 eligible studies from 5 articles enrolling a total of 453 patients were entered into the current meta-analysis. Upon EPO treatment, there were significant differences in the change in hemoglobin (HB) levels compared with the placebo at short-term follow-up [mean difference (MD)=0.66; 95% confidence interval (CI), 0.14-1.18; I2=Not applicable; P=0.01) and long-term follow-up (MD=0.10; 95% CI, 0.02-0.18; I2=Not applicable; P=0.01) under the random effects model. For changes in hematocrit (HCT) compared with the placebo, the results revealed there were significant differences at short-term follow-up (MD=2.47; 95% CI, 0.75-4.19; I2=Not applicable; P=0.005) and long-term follow-up (MD=7.60; 95% CI, 6.15-9.05; I2=Not applicable; P<0.00001) under the random effects model. Compared with the placebo in short-term follow-up under the fixed effects model with homogeneity, the result was a significant difference for the transfusion ratio [relative risk (RR)=0.81; 95% CI, 0.67- 0.97; I2=34%; P=0.02) and the transfusion requirements (MD=-0.45; 95% CI, -0.92, 0.03; I2=6%; P=0.07). Funnel plots did not detect any publication bias. These results suggest that EPO was beneficial to alleviate cancer-associated anemia and improve survival outcomes for patients with cancer.
本研究旨在评估促红细胞生成素（EPO）改善癌症相关恶性贫血的有效性。按照Cochrane手册进行检索，使用包括PubMed、EMBASE、Cochrane图书馆和ClinicalTrails.gov在内的电子数据库，检索截至2015年8月15日的随机临床试验。共有来自5篇文章的6项符合条件的研究纳入了本荟萃分析，共453例患者。在EPO治疗后，随机效应模型下，与安慰剂相比，短期随访时血红蛋白（HB）水平变化有显著差异[平均差（MD）=0.66；95%置信区间（CI），0.14 - 1.18；I2=不适用；P=0.01]，长期随访时也有显著差异（MD=0.10；95% CI，0.02 - 0.18；I2=不适用；P=0.01）。与安慰剂相比，红细胞压积（HCT）变化在随机效应模型下短期随访时有显著差异（MD=2.47；95% CI，0.75 - 4.19；I2=不适用；P=0.005），长期随访时也有显著差异（MD=7.60；95% CI，6.15 - 9.05；I2=不适用；P<0.00001）。在固定效应模型且具有同质性的短期随访中，与安慰剂相比，输血比例[相对危险度（RR）=0.81；95% CI，0.67 - 0.97；I2=34%；P=0.02]和输血量需求（MD=-0.45；95% CI，-0.92，0.03；I2=6%；P=0.07）有显著差异。漏斗图未检测到任何发表偏倚。这些结果表明，EPO有利于缓解癌症相关贫血并改善癌症患者的生存结局
