Congress Abstracts 2005

90

TREATMENT OF ANEMIA WITH DARBEPOETIN ALFA (ARANESP) IN THE RADIATION ONCOLOGY SETTING. Donna Finney, APRN-BC, OCN^®, and Ron Allison, MD, East Carolina University, Greenville, NC.

Anemia is common in patients undergoing radiation therapy, with an estimated incidence of 40%–60% (Harrison, 2000). Failure to diagnose and treat anemia has significant consequences on patient outcomes. Anemia contributes to hypoxia of tumors, associated with decreased radiosensitivity and increased incidence of local failure and distant metastasis (Feldmann, 1999). Diminished quality of life and fatigue resulting from anemia contribute to missed treatment visits. In the radiation oncology setting, anemia-directed interventions are not routinely implemented. Oncology nurses are in the ideal position to evaluate patient outcomes, and provide education, therapy and support.

This project will evaluate the efficacy of darbepoetin alfa intervention for the treatment of anemia in patients undergoing radiation therapy, as measured by quality of life, hemoglobin (Hb), cancer recurrence, and survival and compliance to therapy. Darbepoetin alfa is a unique erythropoietic molecule that is well-tolerated and effective in the treatment of chemotherapy-induced anemia, with a 3-fold longer half-life than recombinant human erythropoietin which allows for less frequent administration (Egrie, 2003). Design and baseline characteristics will be presented (start date August 2004).

Darbepoetin alfa will be administered subcutaneously once every other week, and titrated to maintain Hb within the target range of 11 to 12 g/dL. Anemia is defined by Hb < 11 g/dL. Quality of life and fatigue will be measured by the FACT-Fatigue questionnaire (Cella, 1997). Data will be obtained on erythropoietic therapy, tumor type, disease status and progression. Patients undergoing chemotherapy will be excluded.

Approximately, 70 patients per day have radiation therapy at the Brody School of Medicine, East Carolina University. Patients will be evaluated weekly by a nurse practitioner or physician. Following treatment, monitoring will be done every 3 months for the first year and every 6 months thereafter for 5 years.

Anemia interventions have shown potential to increase the effectiveness of curative-intent radiation therapy, demonstrating that the strategy of overcoming tumor hypoxia may be a viable and important approach. The longer half-life of darbepoetin alfa allows for fewer interventions. As patient advocates, oncology nurses may implement anemia-directed interventions in clinical practice, and examine quality of life in patients undergoing radiation therapy.