The Effects of Epoetin Alfa on Transfusion Requirements in Head and Neck Cancer Patients: A Prospective, Randomized, Placebo‐Controlled Study

Scott, Stacy N.; Boeve, Thomas J.; McCulloch, Timothy M.; Fitzpatrick, Kari A.; Karnell, Lucy Hynds

doi:10.1097/00005537-200207000-00015

Cited by 49 publications

(33 citation statements)

References 60 publications

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“…2,21 In our study, neither tumor size nor nodal status was correlated with the Hb decrease. Twenty percent of patients with T1-T2 tumors had an Hb decrease of B38 g/l, whereas 26% of the patients with T3-T4 an Hb decrease of [38 g/l.…”

Section: Discussioncontrasting

confidence: 78%

“…Moreover, numerous studies pointed out that low hemoglobin (Hb) levels before and during radiation therapy (RT) were associated with worse local control and survival in the various types of cancer. [1][2][3] Head and neck cancer patients are at high risk for developing anemia. Extensive radical surgery, being one of the important reasons, may cause high intraoperative blood loss.…”

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confidence: 99%

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Decrease in Hemoglobin Levels Following Surgery Influences the Outcome in Head and Neck Cancer Patients Treated with Accelerated Postoperative Radiotherapy

et al. 2009

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Aim. To assess the influence of hemoglobin (Hb) levels in locally advanced head and neck cancer (LAHNC) patients treated with surgery and postoperative radiotherapy (PORT). Material and Methods. Pre-and postoperative Hb levels were collected in 79 patients treated with surgery followed by accelerated PORT for LAHNC. Median follow-up was 52 months (range 12-95 months). Results and Discussion. Four-year overall survival (OS) rate was 51%. Neither pre-nor postoperative Hb level (\120 or 130 g/l in women or men, respectively) influenced the outcome. However, when Hb decrease between pre-and postoperative Hb values was taken into account, 4-year OS was significantly higher in patients with Hb difference less than 38 g/l (quartile value) compared with those with Hb decrease 38 g/l or more (61% versus 16%, P = 0.008). Conclusion. Decrease in Hb level by more than 38 g/l after surgery secondary to blood loss influences the outcome when postoperative RT is indicated.

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Section: Discussioncontrasting

confidence: 78%

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confidence: 99%

Decrease in Hemoglobin Levels Following Surgery Influences the Outcome in Head and Neck Cancer Patients Treated with Accelerated Postoperative Radiotherapy

et al. 2009

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“…Clinical trials with erythropoietin and acute normovolaemic haemodilution have shown promising results in the reduction of allogenic blood product requirements in maxillofacial surgery; however, the importance of the meticulous surgical technique cannot be overemphasised (Scott et al, 2002;Habler et al, 2004). Clinicians must be cognizant of the 3 unit threshold and should attempt to limit transfusion volume whenever it is safe to do so.…”

Section: Discussionmentioning

confidence: 99%

The influence of allogenic blood transfusion in patients having free-flap primary surgery for oral and oropharyngeal squamous cell carcinoma

et al. 2006

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The influence of perioperative blood transfusion in oral and oropharyngeal squamous cell carcinoma remains uncertain. It is believed that blood transfusion downregulates the immune system and may have an influence on cancer recurrence and survival. In all, 559 consecutive patients undergoing primary surgery for oral and oropharyngeal squamous cell carcinoma between 1992 and 2002 were included in this study. Known prognostic variables along with transfusion details were obtained from head and neck cancer and blood transfusion service databases, respectively. Adjusting for relevant prognostic factors in Cox regression, the hazard ratio for patients having 3 or more transfused units relative to those not transfused was 1.52 (95% confidence interval (CI) 0.93 -2.47) for diseasespecific and 1.52 (95% CI 1.05 -2.22) for overall mortality. Blood transfusion of 3 or more units might confer a worse prognosis in patients undergoing primary surgery for oral and oropharyngeal squamous cell carcinoma. Therefore, every effort should be made to limit the amount of blood transfused to the minimum requirement.

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“…The search obtained 6 eligible studies from 5 articles (22)(23)(24)(25)(26), which enrolled a total of 595 patients. The change in HB was reported in 2 studies (23,26), the transfusion requirements were noted from 3 studies (23,25), the ratio of transfusion was obtained from a total of 233 of 495 patients from 5 studies (22)(23)(24)(25)(26) and the change in HCT was reported in 2 studies (23,26). Table I presents the clinical characteristics from all studies.…”

Section: Resultsmentioning

confidence: 99%

Erythropoietin for cancer-associated malignant anemia: A meta-analysis

Zhao¹,

Wang²,

Liu³

et al. 2017

Molecular and Clinical Oncology

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Abstract. The present study aimed to evaluate the effectiveness of erythropoietin (EPO) for improving cancer-associated malignant anemia. A search was performed for randomized clinical trials, conducted according to the Cochrane manual, using electronic databases including PubMed, EMBASE, the Cochrane Library and ClinicalTrails.gov up to 15 August 2015. A total of 6 eligible studies from 5 articles enrolling a total of 453 patients were entered into the current meta-analysis. Upon EPO treatment, there were significant differences in the change in hemoglobin (HB) levels compared with the placebo at short-term follow-up [mean difference (MD)=0.66; 95% confidence interval (CI), 0.14-1.18; I 2 =Not applicable; P=0.01) and long-term follow-up (MD=0.10; 95% CI, 0.02-0.18; I 2 =Not applicable; P=0.01) under the random effects model. For changes in hematocrit (HCT) compared with the placebo, the results revealed there were significant differences at short-term follow-up (MD=2.47; 95% CI, 0.75-4.19; I 2 =Not applicable; P=0.005) and long-term follow-up (MD=7.60; 95% CI, 6.15-9.05; I 2 =Not applicable; P<0.00001) under the random effects model. Compared with the placebo in short-term follow-up under the fixed effects model with homogeneity, the result was a significant difference for the transfusion ratio [relative risk (RR)=0.81; 95% CI, 0.67-0.97; I 2 =34%; P=0.02) and the transfusion requirements (MD=-0.45; 95% CI, -0.92, 0.03; I 2 =6%; P=0.07). Funnel plots did not detect any publication bias. These results suggest that EPO was beneficial to alleviate cancer-associated anemia and improve survival outcomes for patients with cancer.

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The Effects of Epoetin Alfa on Transfusion Requirements in Head and Neck Cancer Patients: A Prospective, Randomized, Placebo‐Controlled Study

Cited by 49 publications

References 60 publications

Decrease in Hemoglobin Levels Following Surgery Influences the Outcome in Head and Neck Cancer Patients Treated with Accelerated Postoperative Radiotherapy

Decrease in Hemoglobin Levels Following Surgery Influences the Outcome in Head and Neck Cancer Patients Treated with Accelerated Postoperative Radiotherapy

The influence of allogenic blood transfusion in patients having free-flap primary surgery for oral and oropharyngeal squamous cell carcinoma

Erythropoietin for cancer-associated malignant anemia: A meta-analysis

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