Tuesday, 27 May 2008

Medical oncology, 2008 vol. 25, no. 1

Correlation of quality of life with tumor response in patients receiving palliative chemotherapy for advanced gastrointestinal tumors.
p. 81-7
Shin-Dong-Bok, Bang-Soo-Mee, Park-Se-Hoon et al
We prospectively evaluated the association of tumor response with change of quality of life (QOL) in patients with advanced gastrointestinal tumors receiving palliative chemotherapy. Out of 133 eligible patients, 90 (68%) completed the European Organization for Research and Treatment Quality of Life Questionnaire C-30 (EORTC QLQ C-30) at baseline and at regular intervals during palliative chemotherapy. Among the 90 available patients, 88 patients could be evaluated for response, and 32 (36%) responded. Taking into account 32 patients who had stable disease, 64 (73%) achieved a clinical benefit, defined as an objective response or stable disease. Improvement in the emotional functioning or global QOL was observed before the fourth cycle of chemotherapy in responders (P = 0.039) and patients with clinical benefit (P = 0.026). Grade 3 or 4 toxic effects occurred in 39% of patients; however, this did not adversely affect the global or other domains of QOL. Therefore, change of QOL during the chemotherapy was closely related with clinical outcomes. We should apply the QOL assessment to all patients who received palliative chemotherapy for their gastrointestinal tumors.

Survival and erythropoietin receptor protein in tumours from patients randomly treated with rhEPO for palliative care.
p. 22-9
Loennroth-Christina, Svensson-Marie, Wang-Wenhua, Koerner-Ulla et al
BACKGROUND: Recombinant erythropoietin (rhEPOalpha) corrects anaemia, improves physical functioning and quality of life in cancer patients. However, published reports have suggested risks for tumour stimulation by provision EPO to patients with remaining tumour cells perhaps related to the presence of EPO receptor protein in tumour tissue. Therefore, the aim of the present study was to exclude a possibility that cancer patients who respond favourably to EPO treatment have mainly tumours with low EPO receptor protein expression. METHODS: Tumour tissue was evaluated in 87 patients out of 108 randomly allocated for treatment with rhEPOalpha (n = 50) versus controls (n = 58). Tumour cell proliferation (Ki-67 index) and EPO receptor protein expression were evaluated by immunohistochemistry. RESULTS: EPO treatment varied between 2 and 35 months, in doses between 10,000 and 40,000 Units/week. Ki-67 index did not differ between study and control patients before EPO treatment. Tumour tissue erythropoietin receptor protein was also similar between treated and untreated patients. Around 40% of tumour cells contained EPO receptors. Survival did not differ among EPO treated and control patients analysed as intention to treat, while survival was significantly improved in EPO treated patients per protocol treatment (P < 0.05). Ki-67 index and tumour tissue erythropoietin receptor protein did not predict survival, which systemic inflammation (ESR) did (P < 0.02). CONCLUSIONS: Our results support that reported risk to accelerate disease progression by EPO treatment in palliative care is not justified in patients with solid, gastrointestinal cancer despite tumour presence of EPO receptor protein.

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