title: Erythropoietin administration during primary treatment for locally advanced cervical carcinoma is associated with poor response to radiation.
abstract: The purpose of this study was to determine whether the use of recombinant erythropoietin (r-EPO) during treatment for locally invasive carcinoma of the cervix affects recurrence rates, disease-free survival, and overall survival. Retrospective analysis of outcomes of patients with locally advanced cervical cancer treated with radiation and concurrent chemotherapy between January 1997 and July 2004 was performed. Recurrence rates, disease-free survival, and overall survival were calculated using SPSS statistical software. Throughout P < 0.05 was considered significant. Of 68 patients included in this study, 18 patients received erythropoietin during treatment and 50 did not. Patient age, stage, hemoglobin at presentation, and average weekly hemoglobin (AWH) were similar in both groups of patients. The recurrence rate among patients who received r-EPO was 61% compared with 30% among patients who did not receive r-EPO (P = 0.014). Eight of 18 patients (44%) who received r-EPO were alive at last known follow-up compared to 36 of 50 (72%) who did not receive the medication (P = 0.045). Disease-free survival and overall survival were significantly shorter in patients who received r-EPO during treatment (P = 0.028, 0.032). The administration of r-EPO during primary treatment of patients with locally advanced cervical cancer is associated with increased recurrence rate, increased risk of death due to disease, and decreased disease-free and overall survivals.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, SUNY Downstate Medical Center, Brooklyn, New York 11203, USA. sarah.temkin@gmail.com
authors.forename: S M
authors.initials: SM
authors.lastname: Temkin
authors.forename: M
authors.initials: M
authors.lastname: Hellmann
authors.forename: E
authors.initials: E
authors.lastname: Serur
authors.forename: Y-C
authors.initials: YC
authors.lastname: Lee
authors.forename: O
authors.initials: O
authors.lastname: Abulafia
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000517:prevention & control; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004307:Dose-Response Relationship, Radiation; D004921:Erythropoietin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D011994:Recombinant Proteins; D012008:Recurrence; D012189:Retrospective Studies; D013923:Thromboembolism / Q000209:etiology; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy
chemical_list: D000970:Antineoplastic Agents; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin