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Right arrow Esophagus - cancer

Ann Thorac Surg 2006;82:293-297
© 2006 The Society of Thoracic Surgeons

Original article: General thoracic

Erythropoietin-alfa During Neoadjuvant Chemotherapy for Locally Advanced Esophagogastric Adenocarcinoma

Kathrin Abbrederis, MD a , Florian Bassermann, MD a , Christoph Schuhmacher, MD b , Verena Voelter, MD e , Raymonde Busch, MS c , Nadine Roethling d , Andreas Sendler, MD b , Joerg R. Siewert, MD b , Christian Peschel, MD a , Florian Lordick, MD a , *

a Third Department of Medicine (Hematology/Oncology), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
b Department of Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
c Institute for Medical Statistics and Epidemiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
d Munich Center for Clinical Studies, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
e Multidisciplinary Oncology Center, University Hospital CHUV, Lausanne, Switzerland

Accepted for publication January 26, 2006.

* Address correspondence to Dr Lordick, Third Medical Department (Hematology/Oncology), Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str 22, D-81675 Munich, Germany (Email: f.lordick{at}lrz.tu-muenchen.de).

BACKGROUND: In a previous study we showed that many patients with esophagogastric adenocarcinoma experience anemia during neoadjuvant chemotherapy. We now investigated the role of erythropoietin in managing anemia during neoadjuvant chemotherapy.

METHODS: Patients with esophagogastric adenocarcinoma who experienced anemia (hemoglobin < 12 g/dL) during neoadjuvant treatment received erythropoietin 10,000 IE subcutaneously three times a week. Primary outcomes were the response to erythropoietin, safety, the need for allogeneic red blood cell transfusion, and the rate of postoperative complications.

RESULTS: Between April 2003 and December 2004, 24 patients (median age, 62 years) were enrolled. The mean hemoglobin level before chemotherapy was 12.5 g/dL and the mean hemoglobin level before patients received erythropoietin was 11.5 g/dL. One year after involvement in the trial, 4 of 17 analyzable patients were still anemic (hemoglobin level < 12 mg/dL). Twenty-two patients received erythropoietin, and 16 (73%) responded. We could observe a significant increase in hemoglobin concentrations under therapy with erythropoietin to 12.6 g/dL (p < 0.001). Two patients (8%) received allogeneic transfusions; the rate of postoperative complications was 16%. There were no erythropoietin-related adverse events.

CONCLUSIONS: Treatment with erythropoietin is effective and well tolerated in patients with esophagogastric adenocarcinoma who experience anemia during neoadjuvant chemotherapy.






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