Anaemia as a prognostic factor for the therapeutic effect of radiosensitizers

Results are reported of a clinical trial on the effect of metronidazole as an adjuvant radiosensitizer in the radiation treatment of cervix carcinomas in advanced stages. Analysis of the results was made with regard to the local clearance of the tumour and with haemoglobin level as a stratifying factor (less than 120 g/l or greater than/equal to 120 g/l at presentation). With no metronidazole treatment, the results in anaemic patients were inferior in comparison to patients with normal haemoglobin level. Metronidazole significantly improved the results in the anaemic cases, but had no effect on the non-anaemic patients. Without stratification with respect to anaemia, no significant difference between the metronidazole-treated and untreated control group was noted. It is concluded that anaemia has a prognostic value, and anaemic patients may represent a particular group for which hypoxic cell sensitizers can be expected to improve the effect of radiotherapy.