不同剂量rhEPO治疗131例癌症贫血的临床疗效评价

Recombinant Human Erythropoietin at Different Doses for in Cancer-Associated Anemia: Clinical Efficacy Evaluation on 131 Cases

目的:对不同剂量的重组人红细胞生成素(rhEPO)治疗癌症贫血的临床疗效进行评价。方法:将符合条件的131例癌症贫血患者随机分入6个研究组,分别为5个rhEPO组(rhEPO剂量各为50U/kg、100U/kg、150U/kg、200U/kg、400U/kg)和1个对照组,共观察8周,每2周进行1次rhEPO的疗效观察和指标检测。结果:①患者Hb值和Hct值在应用rhEPO后呈明显上升趋势,4周～6周后与治疗前相比差异有统计学意义(P<0.05或P<0.01)。其中50U/kg组在治疗6周后显效,其它剂量组均为4周显效。②rhEPO50U/kg组的有效率低于其它各rhEPO组(P<0.05或P<0.01),其治疗后4周和8周的有效率分别为9.1%(P>0.05)和27.3%(P<0.05);其它各rhEPO组(100U/kg～400U/kg)之间的有效率无统计学差异(P>0.05),其治疗后4周和8周的有效率分别为28.6%～36.8%(P<0.05或P<0.01)和57.1%～68.4%(P<0.01)。各rhEPO组的不良反应发生率和输血需求率与对照组相比,差异无统计学意义(P>0.05)。结论:在一定的剂量范围内(50U/kg～400U/kg,每周3次),rhEPO治疗癌症贫血以及预防化疗性贫血具有一定的疗效和相对的安全性。②不同剂量rhEPO治疗癌症贫血的疗效不同。rhEPO50U/kg组的疗效低于其它各剂量组,而在100U/kg～400U/kg的剂量范围内,rhEPO的疗效无统计学差异。

OBJECTIVE： To study the clinical effect of recombinant human erythropoietin （rhEPO） at different doses on cancer- associated anemia. METHODS： A total of 131 patients with a confirmed diagnosis of cancer eligible for inclusion were divided into 6 groups： 5 （rhEPO） groups Cat doses of 50U/kg, 100U/kg, 150U/kg, 200U/kg and 400U/kg, respectively） and 1 control group. The efficacy of all groups was compared and the indexes were detected every two weeks during treatment of total eight weeks. RESULTS： There was an upward trend in Hb and hematocrit levels in rhEPO groups after administration, and .a statistical significance was noted 4 to 6 weeks after medication as compared with baseline levels （ P 〈 0.05 or P 〈 0.01）, with the 50U/kg group showing efficacy at 6 weeks, and at 4 weeks for the other rhEPO groups. The effective rates in the 50U/kg group stood at 9.1% （ P 〉 0.05） and 27.3 % （ P 〈 0.05） respectively at 4 and 8 weeks, lower than in the other rhEPO groups （ P 〈 0.05 or P 〈 0.01 ）. The effective rates among the other rhEPO groups were 28.6%-36.8%（P〈0.05 or P〈0.01） and 57.1% -68.4% （P〈0.01） at 4 and 8 weeks, showing no statistical differences （ P 〉 0.05）. The adverse events and blood transfusion demand rates in all rhEPO groups showed no statistical significance as compared with those in control group （P 〉 0.05）. CONCLUSION： Within a dose range from 50U/kg to 400U/kg （thrice weekly）, rhEPO is safe and effective in treating cancer- associated anemia and preventing chemotherapyinduced anemia. However, the efficacy of rhEPO varies at different.doses, with 50U/kg group showing the lowest efficacy, but no statistical differences were noted within a dose range of 100U/kg - 400U/kg.