Influence of anemia on tumor response to preoperative chemoradiotherapy for locally advanced rectal cancer

Lee, Seong Dae; Park, Ji Won; Park, Kui Seon; Lim, Sangwoo; Chang, Hee Jin; Kim, Dae Yong; Jeong, Seung‐Yong; Choi, Hyo Seong; Oh, Jae Hwan

doi:10.1007/s00384-009-0762-7

Cited by 32 publications

(30 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results were consistent with these studies showing that pretreatment anemia could affect the clinical outcome in Korean patients as well. Although Lee et al [17] also investigated the predictive role of anemia in Korean patients treated with NACRT, in that they focused on whether anemia influences the pathologic response, our results showed further that it could be one of prognostic factor affecting local control.…”

Section: Discussionmentioning

confidence: 57%

Negative impact of pretreatment anemia on local control after neoadjuvant chemoradiotherapy and surgery for rectal cancer

Lee

Park

et al. 2012

Radiat Oncol J

View full text Add to dashboard Cite

PurposeAlthough anemia is considered to be a contributor to intra-tumoral hypoxia and tumor resistance to ionizing radiation in cancer patients, the impact of pretreatment anemia on local control after neoadjuvant concurrent chemoradiotherapy (NACRT) and surgery for rectal cancer remains unclear.Materials and MethodsWe reviewed the records of 247 patients with locally advanced rectal cancer who were treated with NACRT followed by curative-intent surgery.ResultsThe patients with anemia before NACRT (36.0%, 89/247) achieved less pathologic complete response (pCR) than those without anemia (p = 0.012). The patients with pretreatment anemia had worse 3-year local control than those without pretreatment anemia (86.0% vs. 95.7%, p = 0.005). Multivariate analysis showed that pretreatment anemia (p = 0.035), pathologic tumor and nodal stage (p = 0.020 and 0.032, respectively) were independently significant factors for local control.ConclusionPretreatment anemia had negative impacts on pCR and local control among patients who underwent NACRT and surgery for rectal cancer. Strategies maintaining hemoglobin level within normal range could potentially be used to improve local control in rectal cancer patients.

show abstract

Section: Discussionmentioning

confidence: 57%

Negative impact of pretreatment anemia on local control after neoadjuvant chemoradiotherapy and surgery for rectal cancer

Lee

Park

et al. 2012

Radiat Oncol J

View full text Add to dashboard Cite

show abstract

“…Tumor oxygenation is affected by several factors, such as adequacy of blood supply, microcirculation, and the oxygen-carrying capacity of the blood, which is expressed as the hemoglobin level. Lee et al [26] reported that tumor response rates in LARC were significantly different below and above a hemoglobin level of 9.0 g/dL. Favorable tumor response (TRG 3-4) was shown in 29% of patients with hemoglobin levels ≥9.0 g/dL, but in no patient with a hemoglobin level <9.0 g/dL.…”

Section: Prediction Of Good Responsementioning

confidence: 99%

An Update on Preoperative Radiotherapy for Locally Advanced Rectal Cancer

Yeo

Kim

2012

J Korean Soc Coloproctol

Self Cite

View full text Add to dashboard Cite

Even in patients undergoing an optimal surgical technique (e.g., total mesorectal excision), radiotherapy provides a significant benefit in the local control of rectal cancer. Compared with postoperative treatment, chemoradiotherapy given preoperatively has been shown to decrease local recurrence rates and toxicity. Additionally, preoperative chemoradiotherapy permits the early identification of tumor responses to this cytotoxic treatment by surgical pathology. Pathological parameters reflecting the tumor response to chemoradiotherapy have been shown to be surrogate markers for long-term clinical outcomes. Post-chemoradiotherapy downstaging from cStage II-III to ypStage 0-I indicates a favorable prognosis, with no difference between ypStage 0 and ypStage I. Research is ongoing to develop useful tools (clinical, molecular, and radiological) for clinical determination of the pathologic chemoradiotherapeutic response before surgery, and possibly even before preoperative treatment. In the future, risk-adapted strategies, including intensification of preoperative therapy, conservative surgery, or the selective administration of postoperative chemotherapy, will be realized for locally-advanced rectal cancer patients based on their response to preoperative chemoradiotherapy.

show abstract

“…The evidence base for the association of pre‐treatment haemoglobin and response to chemoradiotherapy is well established in the oncology literature for a variety of cancers, including those of the head and neck, the uterine cervix, the oesophagus and the anal canal. It is perhaps less well recognized in rectal cancer , as demonstrated by a further contribution in this issue of Colorectal Disease by Khan et al . .…”

mentioning

confidence: 99%

“…. Postulated to occur via a mechanism of diminished tissue oxygenation, it appears that the presence of even subtle degrees of anaemia can lead to a diminished local response to chemoradiotherapy when given for rectal cancer and a worse oncological outcome compared with patients with a pre‐treatment haemoglobin in the normal range . This appears to be an association rather than a causal link, with no controlled studies having been done in which the response to chemoradiotherapy has been studied in rectal cancer patients with corrected anaemia.…”

mentioning

confidence: 99%

Predicting response to chemoradiotherapy in rectal cancer: are we there yet?

Lindsey

2013

Colorectal Disease

View full text Add to dashboard Cite

Influence of anemia on tumor response to preoperative chemoradiotherapy for locally advanced rectal cancer

Abstract: The serum Hb level could be a one of prognostic factors that influences the pathologic tumor response, and pretreatment anemia (below 9.0 g/dl of Hb) is associated with poor response to preoperative CRT.

Cited by 32 publications

References 38 publications

Negative impact of pretreatment anemia on local control after neoadjuvant chemoradiotherapy and surgery for rectal cancer

Negative impact of pretreatment anemia on local control after neoadjuvant chemoradiotherapy and surgery for rectal cancer

An Update on Preoperative Radiotherapy for Locally Advanced Rectal Cancer

Predicting response to chemoradiotherapy in rectal cancer: are we there yet?

Contact Info

Product

Resources

About