[Standards, options and recommendations for the use of recombinant erythropoietin (epoietin alpha and beta darbepoietin-alpha, EPO) in the management of anaemia in oncology for patient undergoing radiotherapy-update 2003].
BACKGROUND
"The Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centres (FNCLCC), the twenty French cancer centres, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery.


OBJECTIVE
To update the Standards, Options and Recommendations clinical practice guidelines for the use of recombinant erythropoietin (epoietin alpha and beta darbepoietin-alpha, EPO) in the management of anaemia in oncology for patient undergoing radiotherapy.


METHODS
The working group identified the questions requiring up-dating from the previous guideline. Medline and Embase were searched using specific search strategies from January 1999 to October 2002. Literature monitoring was performed to identify randomised clinical trials published between October 2002 to November 2003. In addition several Internet sites were searched in October 2002.


RESULTS
There is no standard attitude for use of rHuEPO in patients undergoing radiotherapy. There is no evidence to support use of rHuEPO in patients with ENT cancer receiving radiotherapy alone. In patients undergoing curative radiotherapy, it is recommended to correct anaemia under I Og/dL using transfusion rather than rHuEPO. When the haemoglobin concentration is between 12g/dL and 14g/dL initial use of rHuEPO can be an option under certain conditions for radiochemotherapy if the risk of anaemia is high with the chemotherapy regimen used. Anaemic patients should be included in clinical trials to clarify the impact of rHuEPO in terms of local control of the tumour and survival.
Marchal
Christian
C
Centre Alexis-Vautrin, Nancy, France.
Spaeth
Dominique
D
Casadevall
Nicole
N
Daouphars
Mikaël
M
Marec-Berard
Perrine
P
Fabre
Nicolas
N
Haugh
Margaret
M
D000740:Anemia / Q000188:drug therapy* / Q000209:etiology*; D004921:Erythropoietin / Q000627:therapeutic use*; D005602:France; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007373:Interinstitutional Relations; D009369:Neoplasms / Q000188:drug therapy*; D011787:Quality of Health Care; D011878:Radiotherapy / Q000009:adverse effects*; D011994:Recombinant Proteins
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin