Prognostic Value of Haemoglobin Levels During Concurrent Radio-chemotherapy in the Treatment of Oesophageal Cancer

Rades, Dirk; Lang, Sharon; Schild, Steven E.; Alberti, Winfried

doi:10.1016/j.clon.2005.10.007

Cited by 25 publications

(14 citation statements)

References 25 publications

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“…Tumor stage is the most important prognostic factor for any type of cancer as the planning for optimal treatment is mainly decided accordingly (Nomura et al, 2012). The results of the current study showed that the five year survival rate of our study sample was lower in stages II and IV compared to Netherlands, China and Japan (Christian et al, 2007;Shitara et al, 2010;Nomura et al, 2012) while the rate was higher in stage III compared to Netherlands, China and Germany (Rades et al, 2006;Christian et al, 2007;Shitara et al, 2010). In Conclusion, prognosis of esophageal cancer in North West of Iran is poor, Therefore, reduce the exposure to risk factors and early detection can improve survival in such patients.…”

Section: Discussionmentioning

confidence: 50%

Survival Rate and Prognostic Factors of Esophageal Cancer in East Azerbaijan Province, North-west of Iran

Mirinezhad¹,

Somi²,

Jangjoo³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Section: Discussionmentioning

confidence: 50%

Survival Rate and Prognostic Factors of Esophageal Cancer in East Azerbaijan Province, North-west of Iran

Mirinezhad¹,

Somi²,

Jangjoo³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…It is concordant with previous study: hemoglobin levels of 12-14 g/dl and greater than 14 g/dl during concurrent CRT provided better outcomes than hemoglobin levels less than 12 g/dl. The 2-year overall survival rates were 34%, 35% and 16%, respectively (Rades D, 2006).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of CYFRA21-1, CEA and Hemoglobin in Patients with Esophageal Squamous Cancer Undergoing Concurrent Chemoradiotherapy

Zhang

Wang²,

Huang³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…Haemoglobin levels must be 12-14 g/dl in women and 13-15 g/dl in men to achieve optimal tumour oxygenation and the best results from radiotherapy [5]. Th ese data have been confi rmed in a retrospective study of 108 oesophageal cancer patients, where haemoglobin levels during radiotherapy of 12-14 g/dl resulted in better 2-year loco-regional control than levels <12 g/dl or >14 g/dl (58% vs. 19% and 44%, p < 0.001) [6]. In another retrospective study of 181 patients with non-small cell lung cancer, haemoglobin levels during radiotherapy of <12 g/dl were associated with signifi cantly lower 2-year loco-regional control (29 vs. 41%, p = 0.004) and 2-year overall survival rates (41 vs. 58%, p = 0.013) when compared to haemoglobin levels during radiotherapy of ≥12 g/dl [7].…”

Section: Introductionmentioning

confidence: 76%

Challenges of anemia correction during radiotherapy and chemoradiation

Rades

Schild

2012

memo

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Th e eff ect of radiotherapy depends on optimal tumour oxygenation, as tumour hypoxia impairs the production of radiation-induced cytotoxic free radicals resulting in less tumour cell kill. Th e range of haemoglobin levels optimal for tumour oxygenation is 12-14 g/dl in women and 13-15 g/dl in men. It appears reasonable to elevate the haemoglobin level in anaemic cancer patients into this optimal range. Th is may be achieved with red blood cell transfusions (RBCT) or erythropoiesis stimulating agents (ESAs). However, RBCT have had negligible or even negative eff ect on patient outcome, possibly because RBCT induce immunosuppression or result in haemoglobin levels too high for optimal tumour oxygenation. Several randomized trials have demonstrated that patients irradiated for head-and-neck cancer had worse outcomes with ESAs than the control group. However, in the majority of these trials, over-treatment with ESAs resulted in haemoglobin levels above the optimal range. Tumour oxygenation is impaired by inappropriately high haemoglobin levels due to increased blood viscosity and decreased tumour cell perfusion. Th is concept is supported by the fi ndings of prospective studies in cervix cancer and esophageal cancer patients. In these studies the ESA administration was withheld at a haemoglobin level of 14 g/dl resulting in a positive eff ect of ESAs on treatment outcome. In summary, the eff ect of RBCT and particularly of ESAs during radiotherapy remains unclear. Further randomized trials are required. Until such trials are available, one should follow the ASCO and ESMO guidelines that are very conservative regarding the administration of ESAs during radiotherapy and chemoradiation.

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Prognostic Value of Haemoglobin Levels During Concurrent Radio-chemotherapy in the Treatment of Oesophageal Cancer

Cited by 25 publications

References 25 publications

Survival Rate and Prognostic Factors of Esophageal Cancer in East Azerbaijan Province, North-west of Iran

Survival Rate and Prognostic Factors of Esophageal Cancer in East Azerbaijan Province, North-west of Iran

Prognostic Significance of CYFRA21-1, CEA and Hemoglobin in Patients with Esophageal Squamous Cancer Undergoing Concurrent Chemoradiotherapy

Challenges of anemia correction during radiotherapy and chemoradiation

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