title: Erythropoiesis-stimulating agents in gynecological malignancies: A study-level meta-analysis.
abstract: This meta-analysis was planned to define the role of erythropoiesis-stimulating agents (ESAs) in gynecological cancer patients, receiving myelosuppressive treatment. Pubmed, Medline and Scopus were searched to select English-language articles. Only randomized controlled trials (RCTs) were included. Endpoints were incidence of transfusions, thrombotic events (TE), deaths, and failures. Odd ratio (OR) with 95% confidence interval (CI) was calculated using fixed or random effects model. In seven RCTs ESAs studies of 892 patients under treatment, use of ESAs correlates with a significant reduction of transfusions rate (OR=0.35; 95% CI: 0.19-0.65; p=0.008). OR for overall mortality was 1.10 (95% CI 0.82-1.49; p=0.53). ESAs OR for disease failure in 5 studies was 1.71 (95% CI: 0.90-3.24; p=0.1). This meta-analysis, even if limited by few RCTs, suggests that ESAs reduce transfusions without increasing mortality or disease progression in gynecological cancer patients receiving treatment.
authors.affiliation: Department of Gynecological and Obstetrical Sciences and Urological Sciences, "Sapienza" University of Rome, Viale Regina Elena 326, Rome 00161 Italy.
authors.forename: C
authors.initials: C
authors.lastname: Marchetti
authors.affiliation: Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Viale Regina Elena 326, Rome 00161, Italy. Electronic address: fradefelice@hotmail.it.
authors.forename: F
authors.initials: F
authors.lastname: De Felice
authors.affiliation: Department of Gynecological and Obstetrical Sciences and Urological Sciences, "Sapienza" University of Rome, Viale Regina Elena 326, Rome 00161 Italy.
authors.forename: I
authors.initials: I
authors.lastname: Palaia
authors.affiliation: Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Viale Regina Elena 326, Rome 00161, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Musio
authors.affiliation: Department of Gynecological and Obstetrical Sciences and Urological Sciences, "Sapienza" University of Rome, Viale Regina Elena 326, Rome 00161 Italy.
authors.forename: L
authors.initials: L
authors.lastname: Muzii
authors.affiliation: Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Viale Regina Elena 326, Rome 00161, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Tombolini
authors.affiliation: Department of Gynecological and Obstetrical Sciences and Urological Sciences, "Sapienza" University of Rome, Viale Regina Elena 326, Rome 00161 Italy.
authors.forename: P
authors.initials: P
authors.lastname: Benedetti Panici
mesh_terms: D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D018450:Disease Progression; D004920:Erythropoiesis / Q000187:drug effects*; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000628:therapy
chemical_list: D006397:Hematinics
keywords: Anemia; Chemotherapy; Erythropoiesis-stimulating agents; Gynecological cancer; Mortality; Transfusion