title: Anemia response and safety to epoetin-beta treatment in patients with neoadjuvant therapy prior to primary digestive tract tumor surgery.
abstract: OBJECTIVE
  Anemia is common during anticancer treatment. This study aimed to evaluate the response and safety of treatment with epoetin-beta (EB) in patients with neoadjuvant therapy prior to primary digestive tract tumor surgery.
  
  
  METHODS
  In this open-label, single-arm study, patients (n = 22) with hemoglobin (Hb) levels below 11 g/dl who received epoetin-beta 450 IU/kg (30,000 IU) weekly until the hemoglobin level reached 12 g/dl.
  
  
  RESULTS
  After treatment with EB, a mean absolute increment of 2.6 g/dl was attained. The mean hemoglobin values during the study were pretreatment 10.1 g/dl, half-way through treatment 12.3 g/dl, 4 weeks after concomitant radiochemotherapy 12.7 g/dl, the week prior to surgery 12.5 g/dl, and after surgery 10.9 g/dl. No patient required transfusion before or after surgery. The probability or risk of postoperative complications was 27.3%, and included one rectovaginal fistula, one parastomal hernia, one case of ileus and two surgical wound infections. In this series, downstaging was observed in 81.8% of patients, and downsizing in 90.9%. Most interestingly, histopathological complete response rate was achieved by 18.2%.
  
  
  CONCLUSIONS
  Epoetin-beta (EB) treatment in our series of patients with digestive malignancies subjected to neoadjuvant radiochemotherapy proved effective and safe, avoiding the need for transfusion during surgery.
authors.affiliation: Servicio Oncología Radioterápica, Hospital Clínico Universitario Santiago de Compostela, Travesia Choupana S/N, 15706, Santiago de Compostela, Spain. antonio.gomez.caamano@sergas.es
authors.forename: Antonio
authors.initials: A
authors.lastname: Gómez
authors.forename: Mercedes
authors.initials: M
authors.lastname: Salgado
authors.forename: Manuel
authors.initials: M
authors.lastname: Valladares-Ayerbes
authors.forename: Mónica
authors.initials: M
authors.lastname: Jorge
authors.forename: Ana
authors.initials: A
authors.lastname: Carballo
authors.forename: Sonia
authors.initials: S
authors.lastname: Candamio
authors.forename: Enrique
authors.initials: E
authors.lastname: Castro
authors.forename: Rafael
authors.initials: R
authors.lastname: López
mesh_terms: D000368:Aged; D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004921:Erythropoietin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000628:therapy*; D006397:Hematinics / Q000009:adverse effects / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D011994:Recombinant Proteins; D016896:Treatment Outcome
chemical_list: D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; C103998:epoetin beta; D004921:Erythropoietin