Effects Of Erythropoietin On Chemotherapy-related Anemia In Cancer:a Systematic Review

Objective:To evaluate the efficacy and safety of epoetin-α to chemotherapy-relatedanemia in cancer.Methods:We retrievaled the randomized controlled trial(RCT) in thefollowing databases as the CBM、 CNKI、 Pubmed、 EMBase、 The CochraneLibrary.Conference papers and relevant dates published by Chinese and English were alsomanually searched.Besides,we traced the references from the literatures we had included.Finally,we screened out the RCTs of chemotherapy-related anemia in solid tumorscomparing epoetin-α group with control group.We assessed the quality of the includedstudies by the Cochrane Handbook5.1.2recommend standard,and meta-analyses wereused on the results under RevMan5.1software.Results:A total of8studies containing2122patients were included.Compared with the control group,epoetin-α could increase theincidence of thrombotic events[RR=1.71,95%CI(1.14,2.58),P=0.009],but it can’t add theserious adverse events rate[RR=1.07,95%CI(0.87,1.32),P=0.50]and patients’ totalmortality[RR=1.06,95%CI(0.94,1.20),P=0.31],besides,epoetin-α could increase the meanchange of hemoglobin[SMD=0.53,95%CI(0.32,0.74),P＜0.00001],and cut down the bloodtransfusion rate[RR=0.52,95%CI(0.38,0.70),P＜0.0001]and blood transfusions[SMD=-0.41,95%CI(-0.54,-0.28),P＜0.00001]of the experimental group.Moreover,it canimprove patients’ hemoglobin response rate and quality of life,but there were no statisticalsignificance(P＞0.05)in Median survival time(MST)、Progression-free survival rate(PFS)、Relapse-free survival rate(RFS)and Time to disease progression(TTP).Conclusions:Evidence indicates that,epoetin-α may raise the incidence of thrombotic events but it wasunable to increase the patients’ total rate of death and the serious adverse event,so weshould use it carefully.However,well-designed RCTs with high-quality and a largersample size are still needed.