Quality-of-life benefit in chemotherapy patients treated with epoetin alfa is independent of disease response or tumor type: Results from a prospective community oncology study
Quality-of-life benefit in chemotherapy patients treated with epoetin alfa is independent of disease response or tumor type: Results from a prospective community oncology study
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DOI：
10.1200/jco.1998.16.10.3412
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发表时间：
1998-10-01
影响因子：
45.3
通讯作者：
Cella, D
中科院分区：
文献类型：
--
作者：
Demetri, GD;Kris, M;Cella, D
目的：根据生活质量参数和血红蛋白水平的变化，前瞻性地评估促生成素作为癌症患者化疗辅助药物的有效性，并将这些变化与抗肿瘤反应联系起来。患者和方法：来自621个美国社区实践的2,370名接受化疗的非髓系恶性肿瘤患者被纳入本研究。患者接受每周一次10000 U的促生成素治疗，根据第4周时的血红蛋白反应可增加到每周一次20000 U，如果患者出现血液学反应，治疗最多持续16周。结果：2,289例患者（97%）符合疗效分析。促生成素治疗与改善生活质量参数相关；这些改善与血红蛋白水平显著相关，独立于肿瘤反应，提供者报告Karnofsky表现评分与生活质量的改善变化无关。促生成素治疗也与血红蛋白水平的显著增加和输血使用的减少有关，肿瘤类型、化疗药物/方案、既往化疗、基线血红蛋白水平和基线促红细胞生成素水平不能预测对治疗的积极反应。促生成素耐受性良好。结论：在接受化疗的癌症患者中，Epoetin α似乎对患者报告的功能能力和生活质量有有益的影响，与此同时，Epoetin α似乎可以提高血红蛋白水平并减少输血使用。所有肿瘤类型的患者都有反应，结果表明，促生成素有效地改善了接受化疗的癌症患者的功能预后。(C)美国临床肿瘤学会1998。
Purpose: To evaluate prospectively the effectiveness of epoetin alfa as an adjunct to chemotherapy in patients with cancer based on changes in quality-of-life parameters and hemoglobin levels, and to correlate these changes with antitumor response.Patients and Methods: Two thousand three hundred seventy patients with nonmyeloid malignancies who received chemotherapy were enrolled onto this study from 621 US community-based practices. Patients received epoetin alfa 10,000 U three times weekly, which could be increased to 20,000 U three times weekly depending on the hemoglobin response at 4 weeks, Treatment continued for a maximum of 16 weeks in patients who showed evidence of hematologic response.Results: Two thousand two hundred eighty-nine patients (97%) were eligible for efficacy analyses. Epoetin alfa therapy was associated with improved quality of life parameters; these improvements correlated significantly with hemoglobin levels and were independent of tumor response, Provider reported Karnofsky performance scores did not correlate with the improved quality-of-life changes. Epoetin alfa therapy was also associated with a significant increase in hemoglobin levels and decrease in transfusion use, Tumor type, chemotherapy agent/regimen, prior chemotherapy, baseline hemoglobin level, and baseline erythropoietin level were not predictive of a positive response to treatment. Epoetin alfa was well tolerated.Conclusion: Epoetin alfa appears to have a beneficial impact on patient reported functional capacity and quality of life in patients with cancer who received chemotherapy independent of tumor response, Concordantly, epoetin alfa appeared to increase hemoglobin levels and decrease transfusion use. patients responded across all tumor types, The results suggest that epoetin alfa effectively improves functional outcomes in patients with cancer who receive chemotherapy. (C) 1998 by American Society of Clinical Oncology.