Radiation Oncology Journal  2012;30(3):117-123

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

Hyebin LEE ; Hee Chul PARK ; Won PARK ; Doo Ho CHOI ; Young Il KIM ; Young Suk PARK ; Joon Oh PARK ; Ho Kyung CHUN ; Woo Yong LEE ; Hee Cheol KIM ; Seong Hyeon YUN ; Yong Beom CHO ; Yoon Ah PARK

Keywords

Anemia; Rectal cancer; Neoadjuvant therapy; Concurrent chemoradiotherapy

Country

Republic of Korea

Language

English

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.