| Protection of metabolic and exercise capacity in unselected weight-losing cancer patients following treatment with recombinant erythropoietin: a randomized prospective study. | |
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MedLine Citation:
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PMID: 9850068 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This study was aimed at evaluating whether anemia could be prevented in unselected weight-losing cancer patients on anti-inflammatory treatment by early and prophylactic treatment with recombinant human erythropoietin (rhEPO) and whether such a benefit could be translated into improved physical function and metabolic efficiency. One hundred eight cancer patients who experienced progressive cachexia due to solid, mainly gastrointestinal tumors were randomized to receive twice daily a cyclo-oxygenase inhibitor (controls; indomethacin, 50 mg twice a day) or indomethacin and erythropoietin, provided on individual basis to prevent development of progressive anemia (study patients; indomethacin, 50 mg twice a day plus rhEPO; range, 12,000-30,000 units per week). All patients were treated and followed up until death or to preterminal stage. Biochemical tests (blood, liver, kidney, and thyroid), nutritional state assessment (food intake and body composition), and exercise testing with simultaneous measurements of respiratory gas exchanges before and during exercise were performed before institution of treatments and then at regular intervals during the treatment period (2-30 months after start). Study and control patients did not differ in survival. rhEPO prevented development of anemia during the entire observation period. This was associated with a significantly more preserved maximum exercise capacity in study patients compared to control patients during the follow-up period (101 +/- 10 versus 66 +/- 6 W; P < 0.0001), based on more effective ventilation and whole-body respiratory gas exchanges. These improvements were also evident when exercise performance was normalized to lean body mass, an indirect measure of the skeletal muscle mass. The metabolic efficiency, expressed as oxygen uptake per watt produced, was also significantly preserved in rhEPO-treated patients compared to controls (14.1 +/- 1.1 versus 16.3 +/- 0.9 ml O2/W, P < 0.05). Our results demonstrate that institution of early and prophylactic rhEPO treatment to patients with progressive cancer prevents development of tumor-induced anemia. This achievement was associated with a better preserved exercise capacity, which is explained in part by improved whole-body metabolic and energy efficiency during work load. |
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Authors:
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P Daneryd; E Svanberg; U Körner; E Lindholm; R Sandström; H Brevinge; C Pettersson; I Bosaeus; K Lundholm |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Cancer research Volume: 58 ISSN: 0008-5472 ISO Abbreviation: Cancer Res. Publication Date: 1998 Dec |
Date Detail:
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Created Date: 1998-12-31 Completed Date: 1998-12-31 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 2984705R Medline TA: Cancer Res Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 5374-9 Citation Subset: IM |
Affiliation:
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Department of Surgery and Clinical Nutrition, Sahlgrenska University Hospital, Göteborg University, Sweden. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anemia / blood, etiology, prevention & control* Anti-Inflammatory Agents, Non-Steroidal / therapeutic use Cachexia / blood, chemically induced, drug therapy* Cyclooxygenase Inhibitors / therapeutic use Energy Metabolism Erythropoietin, Recombinant / therapeutic use* Exercise Test Female Humans Indomethacin / therapeutic use Male Middle Aged Neoplasms / complications*, metabolism, physiopathology Prospective Studies Pulse Weight Loss / drug effects* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents, Non-Steroidal; 0/Cyclooxygenase Inhibitors; 0/Erythropoietin, Recombinant; 53-86-1/Indomethacin |
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