蔗糖铁联合EPO治疗晚期肺癌贫血疗效及临床意义探讨  

Efficacy and Clinical Significance of Iron Sucrose Combined with EPO in Treatment of Anemia in Advanced Lung Cancer

作　　者：陈哲[1] 张灵[1] 马峰[2] 高炳华[1] CHEN Zhe;ZHANG Ling;MA Feng;GAO Bin-hua(Department of Hematology,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Medical Oncology,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院血液科,河北张家口075000 [2]河北北方学院附属第一医院肿瘤内科,河北张家口075000

出　　处：《河北北方学院学报（自然科学版）》2021年第4期1-4,10,共5页Journal of Hebei North University:Natural Science Edition

基　　金：张家口市2019年度市级科技计划自筹经费项目(No.1921135H)。

摘　　要：目的探讨蔗糖铁联合促红细胞生成素(erythropoietin,EPO)治疗晚期肺癌患者贫血的疗效及其对生存预后的影响。方法66例晚期肺鳞癌伴轻度-中度贫血且预估生存时间大于3个月的患者,采用单药(吉西他宾或紫杉类)非铂类化疗方案者47(71.2%)例,联合铂类(顺铂或卡铂)化疗者19例(28.8%);完成化疗<4周期者31(47.0%)例,完成化疗≥4个周期者35(53.0%)例;部分Ⅲb期、Ⅳ期患者联合姑息性放疗;所有患者化疗均不少于3个周期。采用蔗糖铁联合EPO治疗贫血。结果蔗糖铁联合EPO治疗后48(72.7%)例有效,18(27.3%)例铁剂治疗无效。2例患者出现低热,1例出现血压轻度升高,整个贫血治疗过程中无血栓性事件、喉头水肿及休克等情况发生。单因素分析中TNM分期、KPS评分、联合疗法是否有效、化疗方式、化疗周期数、近期疗效与预后相关。联合疗法的疗效与肿瘤近期疗效显著相关(φ=0.686,P<0.001)。Cox比例风险回归模型分析结果显示TNM分期、KPS评分、联合疗法是否有效、近期疗效是影响患者生存时间的独立因素。结论蔗糖铁联合EPO能有效改善恶性肿瘤相关性贫血,提高肿瘤对治疗的反应,延长生存时间。Objective To investigate the efficacy of iron sucrose combined with EPO therapy in the treatment for advanced lung cancer patients with anemia and its impact on prognosis.Methods 66 patients with advanced lung squamous cell carcinoma with mild to moderate anemia were estimated to have a survival of more than three months.47(71.2%)patients received single drug(gemcitabine or taxus)non-platinum chemotherapy,and 19(28.8%)patients combined platinum(cisplatin or carboplatin)chemotherapy.31(47.0%)patients completed chemotherapy<four cycles and 35(53.0%)chemotherapy≥four cycles.Palliative radiotherapy was used in some patients with stageⅢb and stageⅣ.All chemotherapies had no less than three cycles.Anemia was treated with iron sucrose combined with EPO.Results 48(72.7%)cases were effective after iron sucrose combined with EPO,and 18(27.3%)cases ineffective after iron treatment.There were 2(3%)patients with low fever,1(1.5%)with mildly elevated blood pressure,and no adverse events(thrombotic events,laryngeal edema and shock)occurred during the whole course of anemia treatment.In the single factor analysis,TNM staging,KPS score,efficacy of combination therapy,chemotherapy mode,number of chemotherapy cycles,and short-term efficacy were correlated with prognosis.The curative effect of the combination therapy was significantly correlated with the short-term efficacy of the tumor(φ=0.686,P<0.001).The analysis results of Cox proportional risk regression model showed that TNM staging,KPS score,curative efficacy of combination therapy and short-term efficacy were independent factors affecting the survival of patients.Conclusion Iron sucrose combined with EPO can effectively improve tumor-associated anemia,improve tumor response to treatment,and prolong survival time.

关 键 词：肿瘤相关性贫血 蔗糖铁 促红细胞生成素 

分 类 号：R734.2[医药卫生—肿瘤] R556[医药卫生—临床医学]