Prognostic Impact of Hemoglobin Level Prior to Radiotherapy on Survival in Patients with Glioblastoma

Odrážka, Karel; Petera, Jiřı́; Kohlová, Tereza; Doležel, Martin; Vaculíková, Miloslava; Zouhar, Milan; Málek, Václav; Hobza, Vladimir; Látr, Ivan; Němeček, S.; Šercl, M; Ryška, Pavel; Bláha, M.; Čermáková, Eva

doi:10.1007/s00066-003-1097-x

Cited by 29 publications

(33 citation statements)

References 30 publications

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“…Nevertheless, several trials provide evidence of a correlation between low a hemoglobin level and local failure or survival rates in patients treated with radiotherapy. The association between low hemoglobin level, hypoxia, and local radiotherapy failure for head and neck [1,2,6,23,28,30] and other solid tumors has also been established [12,[25][26][27]. Unfortunately, to date the impact of hypoxia and low hemoglobin level has not been extensively studied in malignant gliomas as in the other solid tumors; thus, only limited data are available on the influence of this factor on clinical outcome of gliomas.…”

Section: Discussionmentioning

confidence: 99%

“…Only a few researchers have included Hb level in the analysis of prognostic factors and the results obtained are inconsistent [15,20,36]. Lutterbach et al [20] found that hemoglobin levels in GBM did not influence overall survival, while Odrazka et al [23] demonstrated that a low Hb level (≤ 12.0 g/dl) can adversely influence prognosis. Lutterbach et al [19] in a multivariate analysis of prognostic factors established that anemia may negatively influence outcome in patients with malignant gliomas.…”

Section: Background and Purposementioning

confidence: 99%

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Prognostic impact of hemoglobin level and other factors in patients with high-grade gliomas treated with postoperative radiochemotherapy and sequential chemotherapy based on temozolomide

Cèfaro

Genovesi²,

Vinciguerra³

et al. 2011

Strahlenther Onkol

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Section: Discussionmentioning

confidence: 99%

Section: Background and Purposementioning

confidence: 99%

Prognostic impact of hemoglobin level and other factors in patients with high-grade gliomas treated with postoperative radiochemotherapy and sequential chemotherapy based on temozolomide

Cèfaro

Genovesi²,

Vinciguerra³

et al. 2011

Strahlenther Onkol

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“…1,4,25,26 Anemia is also correlated with patient survival, quality of life and treatment compliance. It appears to be one of the most powerful prognostic factor after clinical stage and tumor size.…”

Section: Introductionmentioning

confidence: 99%

Role of recombinant human erythropoietin in patients of advanced cervical cancer treated by chemoradiotherapy

Gupta

Singh²,

Bisth³

et al. 2009

Cancer Biology & Therapy

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Background: Cervical cancer, in women, is the second most common cancer world wide, next to breast cancer. During the treatment of carcinoma cervix, anemia is selectively frequent and its origin is complex combining hemorrhage, iron deprivation, inflammatory reactions and infection. The objective of this study is to evaluate the role of epoetin in correction of anemia and on treatment outcomes in patients with advanced cervical cancer receiving concurrent chemoradiotherapy.Results: A total of 120 patients were enrolled in the study of which 60 patients were randomized to receive epoetin beta in the treatment arm and 60 patients were in control arm where epoetin beta was not given. Total two and three patients absconded during treatment from treatment and control arm respectively; therefore total evaluable patients were 115. Mean Hb at baseline in the control arm was 10.70 g/dl ± 0.62 g/dl and 10.45 g/dl ± 0.43 g/ dl in the treatment arm (p > 0.05). At the end of treatment period mean Hb increased by 1.55 g/dl in patients receiving epoetin beta (p < 0.01), but decreased by 1.50 g/dl in the control arm (p < 0.01).There was significant reduction in blood transfusion in patients receiving epoetin beta (p < 0.01). At the end of treatment there was significant improvement in energy level, activity level and overall quality of life in the treatment arm (p < 0.01).There was no significant difference in overall survival (p > 0.05), or disease free survival (p > 0.05) between the two study arms. Adverse events were well matched between the two study arms. No Thromboembolic events associated with epoetin beta was observed in our study.Material and methods: Total 120, stage IIB to IIIB cervical cancer patients, aged 18-70 years with 9.50-12.50 gm/dl baseline Hb value who were to receive radiotherapy together with cisplatin were randomized to receive either epoetin beta 10,000 IU thrice weekly and oral iron starting 10-15 days before their 5-week course of whole pelvic irradiation and weekly cisplatin (treatment arm) or standard supportive care (control arm), where epoetin beta was not given.Blood transfusion was given in patients of both the arms if hemoglobin was ≤10 gm/dl.Conclusions: Treatment with epoetin beta safely and effectively corrects anemia in patients with advanced cervical cancer receiving chemoradiotherapy and is not associated with adverse effects on response rate, overall survival, disease free survival and chemoradiotherapy related acute and late toxicities.

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“…Operative resection forms the basis of treatment but it is not feasible to effectively resect beyond the limits of macroscopically visible tumor without drastically compromising neurologic function. Adjuvant radiotherapy, however, provides an improvement in the prognosis, increasing the median survival time to about 1 year [13,14,24,28,30,39]. The limited efficacy of radiation treatment is believed to arise from the poor response and apoptosis to ionizing radiation in the tumor cells [17].…”

Section: Introductionmentioning

confidence: 99%

Expression of p53 and p21 in Primary Glioblastomas

et al. 2005

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p53 protein expression in vivo does not correlate with the outcome of patients with primary GBM. Therefore, p53 protein content per se does not appear to be a helpful prognostic factor for prognosis-adapted therapy in primary GBM. By contrast, primary GBM cells in vitro show different and independent responses in their p53 and p21 pathways to ionizing radiation. The failure of G1 arrest seems to be due to a functional defect in the p53 pathway, either because p21 was not induced or because of an unidentified defect downstream from p21.

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Prognostic Impact of Hemoglobin Level Prior to Radiotherapy on Survival in Patients with Glioblastoma

Abstract: The results indicate that lower Hb level prior to radiotherapy for glioblastoma can adversely influence prognosis. This finding deserves further evaluation.

Cited by 29 publications

References 30 publications

Prognostic impact of hemoglobin level and other factors in patients with high-grade gliomas treated with postoperative radiochemotherapy and sequential chemotherapy based on temozolomide

Prognostic impact of hemoglobin level and other factors in patients with high-grade gliomas treated with postoperative radiochemotherapy and sequential chemotherapy based on temozolomide

Role of recombinant human erythropoietin in patients of advanced cervical cancer treated by chemoradiotherapy

Expression of p53 and p21 in Primary Glioblastomas

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