Treatment of chemotherapy induced anemia; a randomized clinical trial to compare quality of life in patients taking intravenous versus oral iron

Abstract

Introduction: Malignancy is one of the causes of anemia in chronic diseases. Anemia can commonly complicate the malignancy process. Objectives: This study aimed to compare improvement in the quality of life and hemoglobin levels between cancer patients with chemotherapy-related anemia receiving erythropoietin and injectable iron supplement versus patients receiving erythropoietin and oral iron supplement. Patients and Methods: This investigation was a randomized clinical trial carried out on 79 anemic individuals with metastatic and non-metastatic carcinoma who were undergoing chemotherapy. Individuals included in the study were randomly assigned to the two groups. The first group received erythropoietin and Venofer while the second group received erythropoietin and ferrous sulfate for 6 weeks. The quality of life for patients was assessed using the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30). Results: Hemoglobin levels in both groups increased significantly while the difference between them was not significant. Despite improvement in more indexes of the questionnaire, post-treatment quality of life in both groups had no significant statistical difference (P>0.05). The changes in indices after interventions showed no difference between the oral and injectable iron supplements groups (P>0.05). Conclusion: The results of this study showed that administration of erythropoietin and iron supplements, either orally or intravenously, even with a shorter duration of treatment could increase hemoglobin levels in chemotherapy-induced anemia group, however to improve the quality of life, it may be necessary to employ larger sample sizes and prolong treatment courses. Trial registration: This randomized controlled trial was registered in the Thai Clinical Trials Registry (identifier: TCTR20200915003; http://www.clinicaltrials.in.th).