Prognostic value of hemoglobin concentrations and blood transfusions in advanced carcinoma of the cervix treated by radiation therapy: Results of a retrospective study of 386 patients

Girinski, T; Pejovic-Lenfant, M.H.; Bourhis, Jean; Campana, F.; Cosset, J.M.; Petit, Christel Le; Malaise, E.P.; Haie, C.; Gerbaulet, A.; Chassagne, D.

doi:10.1016/0360-3016(89)90007-2

Cited by 159 publications

(75 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A small, randomized, prospective study from Princess Margaret Hospital concluded that blood transfusions improved pelvic disease control (57). Girinsky et al found a significant correlation between prognosis and hemoglobin level before and during radiotherapy (58). Our present series using the Kaplan- I 2 1 0 0 0 0 0 0 II 77 1 5 0 2 2 0 III 77 3 7 3 5 4 0 IV 10 1 0 0 1 0 1 Total 185 5 (3) 12 (6) 3 (2) 8 (4) 6 (3) 1 (1) * Bowel obstruction.…”

Section: Discussionmentioning

confidence: 68%

Long-term results of low-dose-rate interstitial-intracavitary brachytherapy in the treatment of carcinoma of the cervix

Syed

Puthawala

Abdelaziz

et al. 2002

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 68%

Long-term results of low-dose-rate interstitial-intracavitary brachytherapy in the treatment of carcinoma of the cervix

Syed

Puthawala

Abdelaziz

et al. 2002

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

“…Most of the literature concerns malignancies of the uterine cervix (Evens and Bergso, 1965;Hierlihy et al, 1969;Vigerio et al, 1973;Bush et al, 1978;Dische et al, 1983;Mendenhall et al, 1984;Bush, 1986;Girinski et al, 1989;Rader, 1990) and head and neck (Blitzer et al, 1984;Overgard et al, 1989;Dubray et al, 1996). How anaemia is causally related to poor outcome is not entirely clear but it is probably both a marker of advanced tumour and indicative of some degree of tissue hypoxia.…”

Section: Discussionmentioning

confidence: 99%

Effect of subcutaneous recombinant human erythropoetin in cancer patients receiving radiotherapy: final report of a randomized, open-labelled, phase II trial

Sweeney

Nicolae²,

Ignacio³

et al. 1998

Br J Cancer

View full text Add to dashboard Cite

Summary The purpose of this study was to determine the safety, efficacy and impact on quality of life of recombinant human erythropoietin (r-HuEPO) for cancer patients undergoing radiotherapy (RT). An open-labelled randomized design was used, with patients randomized to either treatment or control arms. Patients in the treatment arm received r-HuEPO given by subcutaneous injection at a dose of 200 units kg-' day-' plus oral iron supplements (ferrous sulphate 325 mg p.o. t.i.d.). Entry was restricted to patients with carcinoma of the lung, uterine cervix, prostate or breast who presented for RT with anaemia parameters reflective of 'the anaemia of chronic disease'. Radiotherapy policies (portals, doses, fraction size, etc.) were determined by the site and stage of disease. Complete blood counts (CBCs) were obtained weekly. The target level of haemoglobin was 15 g dl-1 for men and 14 g dl-1 for women. Quality of life (QOL) was assessed weekly by using an analogue scale to judge energy, activities of daily living and overall quality of life. Forty-eight patients were entered in the study, 24 in the treatment arm and 24 in the control arm. The prerandomization demographic characteristics and mean laboratory values were comparable in both arms. The mean haemoglobin at completion was 13.6 g dl-1 for r-HuEPO-treated patients compared with 11.0 g dl-1 for control subjects (P= 0.0012). Patients who received r-HuEPO demonstrated a mean weekly haemoglobin increase of 0.41 g dl-1 compared with a decrease in mean haemoglobin level in controls for 6 of the 7 weeks of the study (mean weekly decrease of 0.073 g dl-'). Target levels of haemoglobin were achieved by 41.6% of r-HuEPO-treated patients compared with none of the control subjects. The mean platelet count declined in both arms of the study with RT but the decline from pretreatment was less rapid in r-HuEPO-treated patients (11.2% decrease) compared with controls (26.3% decrease) and was statistically significant during weeks 4-6. Toxicity was minor with only mild irritation at the injection site. Mean quality of life end points were superior in the treatment arm but not statistically significant. r-HuEPO had a beneficial effect on weekly haemoglobin levels in patients undergoing RT with response rates similar to other studies. There was also a less rapid decline in weekly platelet counts in r-HuEPO-treated patients compared with control subjects. Further studies are needed to address the optimum dose and scheduling as well as the impact of r-HuEPO on clinical outcomes.

show abstract

“…However, it is not clear whether low hemoglobin levels are associated with poor survival because they indicate advanced disease or because they indicate poor tumor oxygenation. Current thinking, however, recognizes anemia as a likely contributor to tumor hypoxia [8,11] with a focus on anemia and locoregional failure. The impact of anemia on survival and relapse after radiotherapy has been investigated for a number of tumor types [8,9].…”

Section: Understanding the Impact Of Anemiamentioning

confidence: 99%

“…In this study, patients whose hemoglobin fell below 10 g/dl, 11 g/dl, or 12 g/dl, depending upon the study site, received blood transfusions in order to maintain ANWH above these levels [2]. Finally, in patients with advanced cervical cancer, those patients who maintained hemoglobin levels above 10 g/dl during radiotherapy had improved locoregional tumor control compared with those patients whose on-therapy values fell below 10 g/dl (p < 0.01) [11].…”

Section: Understanding the Impact Of Anemiamentioning

confidence: 99%

Radiotherapy-Associated Anemia: The Scope of the Problem

Harrison

2000

The Oncologist

View full text Add to dashboard Cite

The impact of anemia on cancer patients undergoing chemotherapy is well established, but only recently has the prevalence of anemia in patients receiving radiotherapy received much attention. Many cancer patients present with anemia prior to radiotherapy, and even more experience anemia or a worsening of anemia at some point during treatment. However, the problem of anemia is often ignored because patients may experience only functional anemia, defined as a hemoglobin level less than 12 g/dl. Unless physiologic anemia (hemoglobin = 8 g/dl) is discovered, efforts to correct anemia are often not made. Because hemoglobin levels <12 g/dl seem to be associated with tumor hypoxia and poorer outcomes of radiotherapy in a number of patient populations, ignoring even modest anemia can result in decreased locoregional control, overall survival, and quality of life (QOL). Because increasing hemoglobin levels 1-2 g/dl is usually easily accomplished, there exists the potential for improving outcomes by paying greater attention to this problem. This article focuses on the prevalence of anemia, particularly functional anemia, and discusses the impact of anemia on locoregional control, overall survival, and QOL. INTRODUCTIONContinuing advances in oncology care, including new radiotherapy technologies and recent developments with multimodal therapies, have significantly improved clinical outcomes and quality of life (QOL) for many patients with cancer. However, the prevalence and impact of cancer-associated anemia is not widely appreciated. Emerging data demonstrate that cancer-related anemia is unexpectedly common in cancer patients receiving radiotherapy and/or chemotherapy and that even modest anemia (hemoglobin <12 g/dl) substantially impairs QOL. In addition, a growing body of literature suggests that hemoglobin concentrations of less than 12-13 g/dl during cancer therapy are associated with reduced local tumor control and decreased survival [1,2]. Although anemia of this magnitude can be easily managed, it is often overlooked or considered clinically insignificant. However, restoration of normal hemoglobin concentrations in patients undergoing radiotherapy has the potential to improve local tumor control and survival and produce sizable improvements in patient QOL.

show abstract

Prognostic value of hemoglobin concentrations and blood transfusions in advanced carcinoma of the cervix treated by radiation therapy: Results of a retrospective study of 386 patients

Cited by 159 publications

References 16 publications

Long-term results of low-dose-rate interstitial-intracavitary brachytherapy in the treatment of carcinoma of the cervix

Long-term results of low-dose-rate interstitial-intracavitary brachytherapy in the treatment of carcinoma of the cervix

Effect of subcutaneous recombinant human erythropoetin in cancer patients receiving radiotherapy: final report of a randomized, open-labelled, phase II trial

Radiotherapy-Associated Anemia: The Scope of the Problem

Contact Info

Product

Resources

About