Radiotherapy and anaemia--the clinical experience

Review of the literature shows good evidence of an impaired outlook for anaemic compared with apparently similar, but non-anaemic patients, treated by radiotherapy for tumors at a number of sites. Some of the adverse associations, may be because anaemic patients, compared with the non-anaemic at the same site and with the same clinical stage, may have in actuality a more advanced disease. However, there is good evidence, especially in carcinoma of the cervix, that there occurs an impairment of the response of tumor to radiotherapy in anaemic patients. Where cure is the object of radiotherapy, restoration of the haemoglobin level is necessary before the course is begun. During the past 60 years there has been much interest in the relationship between anaemia and response to radiotherapy. In 25 series of cases where an effect of anaemia has been sought an adverse influence has been found in 23. An examination of these papers, however, reveals a complex pattern demanding some analysis. Anaemia itself requires definition. As can be seen in Fig. 1, there are different normal ranges for men and women and there is some variation in what is accepted as normal. Haemoglobin levels are commonly given in g%, but they are also expressed as mmol/l. There are also reports which refer to the haematocrit. The haemoglobin value at first presentation may be recorded, but the picture may change by the time treatment is instituted, either because of haemorrhage or because of blood transfusion. In examining reports it is sometimes not easy to know which value is related to response.(ABSTRACT TRUNCATED AT 250 WORDS)