Welch R S, James R D, Wilkinson P M, Belli F, Cowan R A
Department of Clinical Oncology, Christie Hospital, Manchester, United Kingdom.
Cancer J Sci Am. 1995 Nov-Dec;1(4):261-6.
Patients with ovarian cancer often experience dose-limiting myelotoxicity, nephrotoxicity and anemia following treatment with platinum-based chemotherapy.
To investigate the ability of recombinant human erythropoietin (epoetin alfa) to prevent the development of anemia, 30 patients with advanced ovarian carcinoma receiving cisplatin or carboplatin were randomly assigned to treatment with subcutaneous epoetin alfa 300 IU/kg three times a week in addition to conventional supportive treatment, or conventional supportive treatment alone, for up to six chemotherapy cycles. The dose of epoetin alfa was reduced if hemoglobin concentration exceeded 15 g/dL.
A highly significant difference in mean hemoglobin concentrations was observed between the two groups during the first cycle of chemotherapy due to a significant decrease in mean hemoglobin concentration in the control group. A maximal difference of 3.4 g/dL was achieved during cycle three. Fewer patients required blood or platelet transfusions in the epoetin alfa-treated group, although the difference was not significant compared to the control group. Epoetin alfa was well tolerated.
Epoetin alfa appears to be effective and well tolerated in preventing hemoglobin decline in patients undergoing aggressive cyclic platinum-based chemotherapy for advanced ovarian carcinoma.
卵巢癌患者在接受铂类化疗后常出现剂量限制性骨髓毒性、肾毒性和贫血。
为研究重组人促红细胞生成素（阿法依泊汀）预防贫血发生的能力，30例接受顺铂或卡铂治疗的晚期卵巢癌患者被随机分为两组，一组在接受常规支持治疗的基础上，每周皮下注射阿法依泊汀300 IU/kg，共三次，持续六个化疗周期；另一组仅接受常规支持治疗。若血红蛋白浓度超过15 g/dL，则降低阿法依泊汀的剂量。
在化疗的第一个周期，由于对照组平均血红蛋白浓度显著下降，两组间平均血红蛋白浓度出现高度显著差异。在第三个周期，最大差异达到3.4 g/dL。在接受阿法依泊汀治疗的组中，需要输血或血小板输注的患者较少，尽管与对照组相比差异不显著。阿法依泊汀耐受性良好。
对于接受积极的周期性铂类化疗的晚期卵巢癌患者，阿法依泊汀在预防血红蛋白下降方面似乎有效且耐受性良好。
