促红细胞生成素在接受化疗的肿瘤患者中的临床应用

Clinical Application of EPO in Common Malignant Patients Receiving Chemotherapy

目的评价促红细胞生成素(epoetin alfa,EPO)对接受化疗的肿瘤患者血红蛋白(hemoglobin,Hb)、输血需求以及生存质量(quality of life,QOL)的影响。方法将79例Hb≤12.0g/dL的恶性肿瘤患者随机分为两组:治疗组接受EPO8000U/次,皮下注射,每周3次,持续8周(EPO组);对照组采用最佳支持治疗(best supportive care,BSC)(BSC组)。观察两组化疗期间Hb变化、输血需求、QOL及不良反应情况。结果在整个治疗过程中EPO组的平均Hb水平保持在12.0g/dL以上,而BSC组的Hb下降。EPO组的Hb反应率为53.8%,明显好于BSC组7.5%(P<0.0001)。EPO组和BSC组的输血需求分别为7.7%、30%(χ2=6.388,P<0.05)。8周时,EPO组的FACT-An贫血及乏力平均分数变化分别为(2.16±12.84)、(3.58±10.52),BSC组分别为(-4.43±13.42)、(-5.34±11.14)(P<0.0001)。两组的不良反应相似。结论EPO能使接受化疗的肿瘤患者保持Hb水平、减少输血需求、提高生存质量。

Objective To evaluate the effects of epoetin alia （EPO） therapy on hemoglobin （Hb） , transfusion requirements and quality of life （QOL） in patients with cancer receiving chemotherapy. Methods Seventy-nine patients with Hb≤12. 0g/dL were randomized to receive EPO 8 000U three times per week s. c（EPO group） or best supportive care（BSC group） for 8 weeks. Hemoglobin responses, transfusion requirements, QOL and toxicity were measured. Results EPO maintained Hb levels throughout the study with mean Hb levels ≥12. 0g/dL, compared with a decrease with BSC. Hemoglobin responses were 53. 8% for EPO group, significantly higher than that in BSC group （7. 5% ） （P〈0. 0001 ）. Transfusion requirements in EPO patients and BSC patients were 7.7% and 30%（Χ^2 = 6. 388, P〈0. 05）, respectively. At the eighth week,mean change score of FACT-An anemia and fatigue was （2. 16 ± 12. 84）, （3. 58 ± 10. 52） for EPO group and （ - 4. 43 ± 13. 42）, （ - 5.34 ± 11.14） for BSC group（P〈0. 0001 for both comparisons）. Adverse events were similar between the groups. Conclusion EPO maintains hemoglobin level, reduces transfusion requirements and improves QOL in patients with cancer receiving chemotherapy.