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Kifle E, Hussein M, Alemu J, Tigeneh W. Prevalence of Anemia and Associated Factors among Newly Diagnosed Patients with Solid Malignancy at Tikur Anbessa Specialized Hospital, Radiotherapy Center, Addis Ababa, Ethiopia. Adv Hematol 2019; 2019:8279789. [PMID: 31781226 PMCID: PMC6855075 DOI: 10.1155/2019/8279789] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/13/2019] [Accepted: 07/31/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Anemia is a common finding in cancer, which is caused by many factors. It is a major cause of morbidity in cancer patients, worsens disease status and impairs treatment outcome; however, little is known about the prevalence of anemia and associated factors among cancer patients during diagnosis in developing countries like Ethiopia. In response to this, we have conducted research with the aim of assessing the prevalence of anemia and associated factors among newly diagnosed patients with solid malignancy at Tikur Anbessa Specialized Hospital (TASH), Radiotherapy center, Addis Ababa, Ethiopia. METHODS Descriptive cross-sectional study was conducted from April to May 2014. A total of 422 newly diagnosed patients with solid malignancy attending Radiotherapy center, TASH were enrolled to assess anemia prevalence and associated factors. Data were coded, entered and analyzed using SPSS version16. Using logistic regression, chi squares, Odds ratio and 95% confidence intervals were computed to measure strength of association between variables. p-value < 0.05 was taken as statistically significant. RESULT Out of 422 respondents, 285 (68%) were females and 153 (36%) of respondents fell into 35-49 age group with age range between 18 and 80 years and the median age of 45. Magnitude of solid cancers was gynecologic (28.9%), breast (22.7%), nasopharyngeal carcinoma (NPC) (7.6%), colorectal (7.1%), sarcoma (6.9%), head and neck (4.5%), thyroid (3.3%), hepatoma (1.9%), and others (17.1%). The overall prevalence of anemia across different tumor was 23% and higher anemia prevalence was noted in gynecologic (37.7%) and colorectal carcinomas (26.7%). The majority of the anemic patients (68%) remained untreated for anemia. The mean trigger hemoglobin for transfusion was 7.7 g/dl. About 83.5% of anemia was mild to moderate type. Performance status (AOR = 3.344; 95% CI 1.410-7.927) and bleeding history (AOR = 3.628; 95% CI 1.800-7.314) showed statistically significant association with occurrence of anemia with p-value < 0.05. CONCLUSION Among solid cancers, gynecologic cancer remained the dominant one. Anemia prevalence was 23% in general, in which gynecologic and colorectal cancers were more prevalent. ECOG performance status and bleeding history showed a statistically significant association with the occurrence of anemia.
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Affiliation(s)
- Edosa Kifle
- Wollega University, Institute of Health Science, Department of Medical Laboratory Science, P.O. Box: 395, Nekemte, Ethiopia
| | - Mintewab Hussein
- Addis Ababa University, School of allied Health Science, Department of Medical Laboratory Science, Addis Ababa, Ethiopia
| | - Jemal Alemu
- Addis Ababa University, School of allied Health Science, Department of Medical Laboratory Science, Addis Ababa, Ethiopia
| | - Wondemagegnhu Tigeneh
- Addis Ababa University, Tikur Anbessa Specialized Hospital, Radiotherapy Center, Addis Ababa, Ethiopia
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Biau J, Chautard E, Miroir J, Lapeyre M. [Radioresistance parameters in head and neck cancers and methods to radiosensitize]. Cancer Radiother 2015; 19:337-46; quiz 360-1, 363. [PMID: 26119219 DOI: 10.1016/j.canrad.2015.02.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 02/06/2015] [Accepted: 02/12/2015] [Indexed: 12/24/2022]
Abstract
Head and neck cancers have been widely studied concerning their sensitivity to radiation therapy. Several parameters affect tumour response to radiation therapy. Some parameters are linked to the tumour. Large or invasive tumours, localization, such as oral cavity or adenopathy, are factors of radioresistance. Others parameters are linked to the patients themselves. Tobacco intoxication during radiotherapy and a low hemoglobin level contribute to radioresistance. More recently, a positive human papilloma virus (HPV) status has been reported to positively affect radiosensitivity. Finally, other parameters are related to tumour biology. Hypoxia, intrinsic radiosensitivity of tumour cells, tumour differentiation and repopulation (provided by Ki-67 index or EGFR level) are components of radiosensitivity. Currently, concurrent chemoradiotherapy is one of the gold standard treatments to overcome clinical outcome of locally advanced head and neck cancer. This combination increases locoregional control and survival. Taxane-based induction chemotherapy can also be an alternative. Another validated approach is the association of radiotherapy with cetuximab (EGFR targeting) but only one randomized study has been published. Fractionation modifications, especially hyperfractionation, have given positive results on both tumour control and survival. Strategies targeting hypoxia improve locoregional control but have less clinical impact.
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Affiliation(s)
- J Biau
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France; EA7283 Cancer Resistance Exploring and Targeting (CREAT), Clermont université, université d'Auvergne, 49, boulevard François-Mitterrand, CS 60032, 63001 Clermont-Ferrand cedex 1, France; Équipe recombinaison, réparation et cancer, UMR 3347, CNRS, centre universitaire, 91405 Orsay cedex, France; Inserm U1021, centre universitaire, 91405 Orsay cedex, France; Institut Curie, 26, rue d'Ulm, 75005 Paris, France.
| | - E Chautard
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France; EA7283 Cancer Resistance Exploring and Targeting (CREAT), Clermont université, université d'Auvergne, 49, boulevard François-Mitterrand, CS 60032, 63001 Clermont-Ferrand cedex 1, France
| | - J Miroir
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France
| | - M Lapeyre
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France
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Thakur P, Seam RK, Gupta MK, Rastogi M, Gupta M, Bhattacharyya T, Sharma M, Revannasiddaiah S. Comparison of Effects of Hemoglobin Levels Upon Tumor Response among Cervical Carcinoma Patients Undergoing Accelerated Hyperfractionated Radiotherapy versus Cisplatin Chemoradiotherapy. Asian Pac J Cancer Prev 2015; 16:4285-9. [DOI: 10.7314/apjcp.2015.16.10.4285] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Errachdi A, Asabbane A, Nkoua Epala B, Hemmich M, Kabbali N, Kebdani T, Benjaafar N. [Advanced cervical cancer: Evolutionary and prognostic. Moroccan experience]. Presse Med 2014; 43:e257-64. [PMID: 25001047 DOI: 10.1016/j.lpm.2014.02.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 09/26/2013] [Accepted: 02/13/2014] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Standard treatment of locally advanced cervical carcinoma is actually represented by concomitant chemoradiotherapy followed by brachytherapy. However, in spite of good local control rates after treatment, local and regional relapses still a major cause of failure treatment. The occurrence of progressions and relapses depends on prognostic factors of disease evolution. Their treatment is often palliative. METHODS The aim of this study is to report the evolution of our retrospective series after radiotherapy with or without concomitant chemotherapy, and to discuss progressions and relapses factors for the stages IIIB and IVA of cervical carcinoma. RESULTS Progressions occurred in 15 patients (13.7%) with an average of three months. Recurrences occurred in 15 patients (13.7%) with an average of 19.6 months. The overall treatment failure rate was 27.5%. Seventy-six of treated patients were in good locoregional control with a median follow of 64 months (61-76). The overall survival at five years was 41.3%. CONCLUSION Relapses of cervical cancer have a poor prognosis and long-term survival remains very poor. The suitable treatment of the primary disease, respecting essentially therapeutic times, is the only guarantee of a good prognosis, as well as screening at early stages, involving less poor prognostic factors.
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Affiliation(s)
- Amal Errachdi
- CHU Ibn Sina, Université Mohamed 5, Institut national d'oncologie Sidi-Mohamed-Benabdellah, service de radiothérapie, 10100 Rabat, Maroc.
| | - Amal Asabbane
- CHU Ibn Sina, Université Mohamed 5, Institut national d'oncologie Sidi-Mohamed-Benabdellah, service de radiothérapie, 10100 Rabat, Maroc
| | - Brice Nkoua Epala
- CHU Ibn Sina, Université Mohamed 5, Institut national d'oncologie Sidi-Mohamed-Benabdellah, service de radiothérapie, 10100 Rabat, Maroc
| | - Mariem Hemmich
- CHU Ibn Sina, Université Mohamed 5, Institut national d'oncologie Sidi-Mohamed-Benabdellah, service de radiothérapie, 10100 Rabat, Maroc
| | - Naoual Kabbali
- CHU Ibn Sina, Université Mohamed 5, Institut national d'oncologie Sidi-Mohamed-Benabdellah, service de radiothérapie, 10100 Rabat, Maroc
| | - Tayeb Kebdani
- CHU Ibn Sina, Université Mohamed 5, Institut national d'oncologie Sidi-Mohamed-Benabdellah, service de radiothérapie, 10100 Rabat, Maroc
| | - Noureddine Benjaafar
- CHU Ibn Sina, Université Mohamed 5, Institut national d'oncologie Sidi-Mohamed-Benabdellah, service de radiothérapie, 10100 Rabat, Maroc
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Xie XZ, Song K, Cui B, Jiang J, Zhang YZ, Wang B, Yang XS, Kong BH. Clinical and pathological factors related to the prognosis of chinese patients with stage Ib to IIb cervical cancer. Asian Pac J Cancer Prev 2013; 13:5505-10. [PMID: 23317208 DOI: 10.7314/apjcp.2012.13.11.5505] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The aim of this retrospective study is to analyze the clinical and pathological factors related to the prognosis of Chinese patients with stage Ib to IIb cervical cancer. METHODS AND RESULTS 13 clinical pathological factors in 255 patients with stage Ib to IIb cervical cancer undergoing radical hysterectomy and systematic lymphadenectomy were analyzed to screen for factors related to prognosis. The cumulative 5-year survival of the 255 patients was 75.7%. The result of the univariate analysis suggested that clinical stage, cell differentiation, depth of cervical stromal invasion, parametrial tissue involvement, and lymph node metastasis were prognostic factors for patients with stage Ib to IIb cervical cancer (P<0.05). Compared with cases with involvement of iliac nodes, obturator nodes, or inguinal lymph nodes, cases with metastasis to the common iliac lymph nodes had a poorer prognosis (P<0.05). Cases with involvement of four or more lymph nodes had a poorer prognosis than those with involvement of three or fewer lymph nodes (P<0.05). Using multivariate Cox proportional hazards model regression analysis, non-squamous histological type, poor differentiation, parametrial tissue involvement, and outer 1/3 stromal invasion were found to be independently related to patients poor prognosis (P<0.05). CONCLUSION Non-squamous histological type, poor cell differentiation, parametrial tissue involvement, and outer 1/3 stromal invasion are the independent poor prognostic factors for patients with stage Ib to IIb cervical cancer.
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Affiliation(s)
- Xiu-Zhen Xie
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan, China
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Abstract
Cancer-related anemia adversely affects quality of life and is associated with reduced overall survival. The correction of anemia in cancer patients has the potential to improve treatment efficacy and increase survival. A large number of studies demonstrate that treatment of anemia in cancer patients using erythropoiesis-stimulating agents (ESAs) significantly increases hemoglobin levels, decreases transfusion requirements and improves quality of life, predominantly by reducing fatigue. Some data on the use of ESAs in cancer patients indicate an increased risk of thromboembolic events and a possibly increased risk of mortality. However, there is ample evidence that when ESAs are used within current guidelines, they are valuable and safe drugs for the treatment of anemia in patients receiving radiotherapy and/or chemotherapy. There are increasing data from prospective, randomized trials demonstrating better responses to ESAs with the concurrent use of iron. Blood transfusions are also helpful in the management of anemia in cancer patients, especially when there is a need for immediate increases in hemoglobin levels. In this article, we discuss recent aspects relating to treatment modalities for anemia in cancer patients.
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Affiliation(s)
- Aknar Calabrich
- Clinica AMO, Rua Altino Serbeto de Barros, 119, 12° andar, Itaigara, Salvador, Bahia 41825-010, Brazil
- Oncology Center, Hospital Sírio-Libanês, R Adma Jafet, 91, São Paulo 01308-050, Brazil
| | - Artur Katz
- Oncology Center, Hospital Sírio-Libanês, R Adma Jafet, 91, São Paulo 01308-050, Brazil
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[Erythropoietin and radiotherapy]. Cancer Radiother 2009; 14:81-6. [PMID: 20018547 DOI: 10.1016/j.canrad.2009.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Revised: 07/02/2009] [Accepted: 08/04/2009] [Indexed: 11/23/2022]
Abstract
Erythropoietin (EPO) is a glycoprotein hormone. This hormone is a growth factor for red blood cells precursors in the bone marrow. The decrease of oxygen partial pressure, a reduced number of erythrocytes caused by bleeding or excessive destruction, or increased tissues oxygen requirements lead to increased secretion of EPO. Its action takes place on bone marrow erythroblastic cells through specific receptors. EPO stimulates the proliferation of red cell precursors stem cells in the bone marrow, thus increasing their production in one to two weeks. The effectiveness of EPO at increasing haemoglobin and improving patients' quality of life has been demonstrated by several studies. However, its use in radiotherapy remains controversial. While tumour hypoxia caused by anaemia is a factor of radio resistance and thus a source of local failure, tumour expression of EPO receptors presents a significant risk for tumour progression and neo-angiogenesis, which would be increased during the administration of EPO. The purpose of this article is to answer the question: is there a place for EPO in combination with radiotherapy in the management of cancer?
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Lim MC, Kim JY, Kim TH, Park S, Kong SY, Yoon JH, Kang S, Seo SS, Park SY. Allogeneic blood transfusion given before radiotherapy is associated with the poor clinical outcome in patients with cervical cancer. Yonsei Med J 2008; 49:993-1003. [PMID: 19108024 PMCID: PMC2628023 DOI: 10.3349/ymj.2008.49.6.993] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To analyze the effect of allogeneic blood transfusion on clinical outcome in 119 patients with stage IIB cervical cancer who were treated with radiotherapy +/- chemotherapy. PATIENTS AND METHODS Medical records were examined for hemoglobin levels before and during radiotherapy, history of allogeneic blood transfusions and the time point when transfusions were given. These factors were retrospectively analyzed along with other clinical risk factors for influences on the patients' clinical outcomes. RESULTS Thirty-two patients (26.9%) received packed red blood cell transfusion (mean, 3.4 units; range, 1-12 units) before or during radiotherapy. Median follow-up period was 39.3 months (range, 7.6-58.4 months). Patients with history of transfusion showed poorer metastasis-free survival and a trend toward poorer overall survival than non-transfused patients. When patients who received transfusions were sub-divided by the time of transfusion, those who received transfusions before radiotherapy had significantly poorer clinical outcome than those who received transfusions during radiotherapy. In a multivariable analysis, patients with pretreatment transfusion showed a higher risk of distant metastasis (HR = 3.75, 95% CI: 1.28-12.15, p = 0.017) and decreased overall survival rates (HR = 4.62, 95% CI: 1.15-18.54, p = 0.031) compared with those of other patients. CONCLUSION Our results suggest that allogeneic blood transfusions given before radiotherapy may be associated with higher incidence of distant metastases and decreased survival in patients with stage IIB cervical cancer.
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Affiliation(s)
- Myong Cheol Lim
- Research Institute and Hospital, National Cancer Center, Gyeonggi, Korea
- Department of Obstetrics and Gynecology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Joo-Young Kim
- Research Institute and Hospital, National Cancer Center, Gyeonggi, Korea
| | - Tae-Hyun Kim
- Research Institute and Hospital, National Cancer Center, Gyeonggi, Korea
| | - Sohee Park
- Research Institute and Hospital, National Cancer Center, Gyeonggi, Korea
| | - Sun-Young Kong
- Research Institute and Hospital, National Cancer Center, Gyeonggi, Korea
| | - Jung-Hyun Yoon
- Research Institute and Hospital, National Cancer Center, Gyeonggi, Korea
| | - Sokbom Kang
- Research Institute and Hospital, National Cancer Center, Gyeonggi, Korea
| | - Sang-Soo Seo
- Research Institute and Hospital, National Cancer Center, Gyeonggi, Korea
| | - Sang Yoon Park
- Research Institute and Hospital, National Cancer Center, Gyeonggi, Korea
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Lartigau E, Dewas S, Gras L. L’effet Oxygène, une cible ancienne toujours d’actualité ? Cancer Radiother 2008; 12:42-9. [DOI: 10.1016/j.canrad.2007.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2007] [Revised: 12/10/2007] [Accepted: 12/12/2007] [Indexed: 01/18/2023]
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