Radiat Oncol J.  2012 Sep;30(3):117-123.

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

• Lee H
• Park HC
• Park W
• Choi DH
• Kim YI
• Park YS
• Park JO
• Chun HK
• Lee WY
• Kim HC
• Yun SH
• Cho YB
• Park YA

Abstract

PURPOSE
Although 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 METHODS
We reviewed the records of 247 patients with locally advanced rectal cancer who were treated with NACRT followed by curative-intent surgery.
RESULTS
The 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.
CONCLUSION
Pretreatment 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.

Keyword

Anemia; Rectal cancer; Neoadjuvant therapy; Concurrent chemoradiotherapy

MeSH Terms

Anemia
Anoxia
Chemoradiotherapy
Hemoglobins
Humans
Multivariate Analysis
Neoadjuvant Therapy
Polymerase Chain Reaction
Radiation, Ionizing
Rectal Neoplasms
Reference Values
Hemoglobins