March 2003 Guideline
The medical literature was searched using the MEDLINE (Ovid) (1966 through January 2003), CANCERLIT (Ovid) (1983 through October 2002), and Cochrane Library (Issue 4, 2002) databases. In addition, the Physician Data Query clinical trials database and abstracts published in the conference proceedings from the meeting of the American Society of Clinical Oncology (1997-2002) were searched for reports of new or ongoing trials. The Canadian Medical Association Infobase and the National Guideline Clearinghouse databases were searched for related clinical practice guidelines. Reference lists from relevant articles and reviews were searched for additional trials.
The literature search combined disease specific terms (neoplasms/ or cancer:.tw. or malignan:.tw. or tumour:.tw.) with treatment specific terms (erythropoietin/ or erythropoietin.mp. or epo.tw. or epoetin.tw. and drug therapy/ or chemotherapy.tw.) with search specific terms for the following study designs: practice guidelines, systematic reviews or meta-analyses, reviews, randomized controlled trials, controlled clinical trials, and economic evaluations.
An additional search was performed using MEDLINE, CANCERLIT, and the Cochrane Library for the same years to locate reports of non-randomized trials evaluating the quality of life of cancer patients receiving erythropoietin. The search terms for erythropoietin described above were combined with "quality of life" (MeSH and text word) or "qol". In addition, the 1998–2002 proceedings of the annual meetings of American Society of Clinical Oncology were also searched for reports of newly completed trials.
March 2005 Update
The medical literature was searched using the MEDLINE (Ovid) (2003 through March 2005), EMBASE (Ovid) (2003 through March 2005), and Cochrane Library (Issue 1, 2005) databases. In addition, the Physician Data Query clinical trials database and abstracts published in the conference proceedings from the meeting of the American Society of Clinical Oncology (2003–2004) and the European Society of Clinical Oncology (2004) were searched for reports of new or ongoing trials. The Canadian Medical Association Infobase and the National Guideline Clearinghouse databases were searched for related clinical practice guidelines. Reference lists from relevant articles and reviews were searched for additional trials.
Inclusion Criteria
Articles were selected for inclusion in this systematic review of the evidence if they were fully published reports or published abstracts and met the following criteria:
- Randomized controlled trials that compared erythropoietin (EPO) with placebo or observation
- Specified outcome measures that could be analysed included the number of patients transfused during the period of follow-up, quality of life, change in hemoglobin, and adverse effects of EPO
- Subjects were patients with cancer receiving chemotherapy
- Non-randomized reports of cancer patients receiving EPO were considered if they reported on quality of life outcomes.
Exclusion Criteria
Articles were excluded from the systematic review of the evidence if they were:
- Trials published in a language other than English
- Trials involving only patients with hematologic malignancies originating in the bone marrow
- Trials involving patients receiving radiotherapy or chemoradiotherapy