Correction of cancer anemia - Impact on disease course, prognosis and treatment efficacy, particularly for patients undergoing radiotherapy

Almost one cancer patient in two is anemic, with a correspondingly poorer p rognosis and quality of life. A low blood hemoglobin level seems to directl y impair treatment efficacy, particularly of radiotherapy, possibly because low tissue oxygenation causes a decrease in radiosensitivity. Tissue hypox ia may also facilitate tumor progression and impair the efficacy of cytosta tic drugs. This constitutes a powerful rationale for correcting cancer anem ia. Red cell transfusion is immediately effective, but carries risks of inf ection and immunosuppression. A safer alternative is recombinant human eryt hropoietin (rhEPO), which has already proved feasible and effective in corr ecting anemia and improving quality of life of cancer patients. Several ong oing radiotherapy studies are presently investigating whether rhEPO conclus ively increases cancer cure rates. First results should be available in 200 1. Given the efficacy of rhEPO to stimulate erythropoiesis and improve qual ity of life of cancer patients and its potential to enhance radiation's eff icacy seem to earn it a firm place at least in the radiooncologist's arsena l.