促红细胞生成素在接受化疗的肿瘤患者中的临床应用

 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。

Clinical Application of EPO in Common Malignant Patients Receiving Chemotherapy

Objective 　To evaluate the effects of epoetin alfa ( EPO) therapy on hemoglobin ( Hb) , transfusion requirements and quality of life (QOL) in patient s with cancer receiving chemotherapy. Methods 　 Seventy-nine patient s 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. 0 g/ 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 requirement s in EPO patient s and BSC patients were 7. 7 % and 30 % (χ2 = 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 event s were similar between the groups. Conclusion 　EPO maintains hemoglobin level , reduces t ransfusion requirements and improves QOL in patient s with cancer receiving chemotherapy.