Epoetin alfa improves survival after chemoradiation for Stage III esophageal cancer: Final results of a prospective observational study

Dirk Rades, Silke Tribius, Emre F. Yekebas, Roia Bahrehmand, Ingeborg Wildfang, Ergin Kilic, Ulrich Muellerleile, Eberhard Gross, Steven E. Schild, Winfried Alberti

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25 Scopus citations

Abstract

Purpose: This prospective, nonrandomized study evaluates the effectiveness of epoetin alfa to maintain the hemoglobin levels at 12 to14 g/dL (optimal range for tumor oxygenation) during chemoradiation for Stage III esophageal cancer and its impact on overall survival (OS), metastatic-free survival (MFS), and locoregional control (LC). Methods and Materials: Ninety-six patients were included. Forty-two patients received epoetin alfa (150 IU/kg, 3 times a week) during radiotherapy, which was started at hemoglobin less than 13 g/dL and stopped at 14 g/dL or higher. Hemoglobin levels were measured weekly during RT. Results: Both groups were balanced for age, sex, performance status, tumor length/location, histology, grading, T-stage/N-stage, chemotherapy, treatment schedule, and hemoglobin before RT. Median change of hemoglobin was +0.3 g/dL/wk with epoetin alfa and -0.5 g/dL/wk without epoetin alfa. At least 60% of hemoglobin levels were 12 to 14 g/dL in 64% and 17% of the patients, respectively (p < 0.001). Patients who received epoetin alfa had better OS (32% vs. 8% at 2 years, p = 0.009) and LC (67% vs. 15% at 2 years, p = 0.001). MFS was not significantly different (42% vs. 18% at 2 years, p = 0.09). Conclusions: The findings suggest that epoetin alfa when used to maintain the hemoglobin levels at 12 to 14 g/dL can improve OS and LC of Stage III esophageal cancer patients.

Original languageEnglish (US)
Pages (from-to)459-465
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume65
Issue number2
DOIs
StatePublished - Jun 1 2006

Keywords

  • Chemoradiation
  • Epoetin alfa
  • Esophageal cancer
  • Locoregional control
  • Survival

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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    Rades, D., Tribius, S., Yekebas, E. F., Bahrehmand, R., Wildfang, I., Kilic, E., Muellerleile, U., Gross, E., Schild, S. E., & Alberti, W. (2006). Epoetin alfa improves survival after chemoradiation for Stage III esophageal cancer: Final results of a prospective observational study. International Journal of Radiation Oncology Biology Physics, 65(2), 459-465. https://doi.org/10.1016/j.ijrobp.2005.12.019