Prevalence and significance of anaemia in patients receiving long-course neoadjuvant chemoradiotherapy for rectal carcinoma

Cheltenham General Hospital, Gloucestershire, UK Anatomy demonstrator Brighton and Sussex Medical School Worcestershire Acute Hospitals NHS Trust.
Colorectal Disease (Impact Factor: 2.02). 05/2012; 15(1). DOI: 10.1111/j.1463-1318.2012.03112.x
Source: PubMed

ABSTRACT Aim:  The study aimed to assess the prevalence and significance of anaemia during long-course neo-adjuvant radiotherapy (LNRT) of rectal cancer at our centre. Method:  Hospital coding and a prospective oncology database were used to identify all patients undergoing LNRT for rectal cancer at our centre between 2004-2009. A retrospective review of computerised records was used to extract individual patient data. Anaemia was defined as a haemoglobin (Hb) level <11.5 grammes/decilitre (g/dL) for men and <13 g/dl for women. Downstaging was assessed by comparing radiological (rTNM) to histological stage (ypTNM). Tumour regression after radiotherapy was assessed using the 'Rectal Cancer Regression Group (RCRG)' scores of 1-3. Results were analysed using GnuPSPP statistical software. Results:  There were 70 patients (51 male) of median age of 66 (IQR 60-72.75) years. Of these 24 were anaemic. Two (3%) had no Hb recorded and were excluded. Forty-two percent of anaemic patients demonstrated mural (T) downstaging compared with 68% of non-anaemic patients (p=0.03). There was no differences in nodal downstaging between the groups. The RCRG scores showed more tumour regression in non-anaemic than anaemic patients as follows: RCRG 1 59% vs 30%, RCRG 2 11% vs 17%, RCRG 3 38% vs 46% (p< 0.001). Conclusion:  The prevalence of anaemia in patients undergoing LNRT was 35%. Anaemia during LNRT was associated with significant reductions in tumour downstaging and regression. © 2012 The Authors Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

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