Rs. Lavey et Wh. Dempsey, ERYTHROPOIETIN INCREASES HEMOGLOBIN IN CANCER-PATIENTS DURING RADIATION-THERAPY, International journal of radiation oncology, biology, physics, 27(5), 1993, pp. 1147-1152
Citations number
31
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Purpose: The hemoglobin (Hgb) level of patients during radiation thera
py is associated with both survival and local tumor control in several
organ sites. This clinical trial tested whether administering recombi
nant human erythropoietin (r-HuEPO) to cancer patients would increase
their Hgb level during the course of radiation therapy without adverse
effects. Methods and Materials: The 40 participating patients had a H
gb value < 13.5 g/dL and a malignant tumor located above the diaphragm
without evidence of distant metastasis for which they were scheduled
to undergo a 5-8 week course of daily radiation therapy. All 40 patien
ts were given oral ferrous sulfate throughout their radiation therapy
course. Half the patients also received 150-300 mg/kg of r-HuEPO subcu
taneously three times per week starting 0-10 days prior to the first d
ose of radiation. Results: The r-HuEPO and control groups did not diff
er significantly in patient age, gender, tumor type, initial hemoglobi
n, erythropoietin, or iron bioavailability. The Hgb level increased mo
re than 6% during radiation therapy in all 20 of the r-HuEPO patients
but in only 2/20 of the control patients (p < 0.001). The Hgb rose fro
m a mean +/- standard deviation of 11.9 +/- 1.3 g/dL to > 14 g/dL duri
ng radiation therapy in 80% of the r-HuEPO group compared to in 5% of
the control group (p < 0.001). The mean +/- s.d. change in Hgb concent
ration during radiation therapy was 27 +/- 15% (an average rise of 5%
per week) in the r-HuEPO group and 0 +/- 6% in the control group (p <
0.001). r-HuEPO had no significant measurable effect on blood pressure
, white blood cell, neutrophil or platelet count, or liver or renal fu
nction. The only reported adverse effect of r-HuEPO administration was
an asymptomatic skin rash in one patient. Conclusion: T-HuEPO with fe
rrous sulfate significantly increased the Hgb level in cancer patients
without interfering with their course of radiation therapy, whereas f
errous sulfate alone did not. r-HuEPO appears to be a safe and effecti
ve means of increasing red cell mass during radiation therapy.