Incidence and impact of anemia in radiation oncology

  • Jürgen Dunst
  • M. Molls


About 45 years ago, Thomlinson and Gray (1955) demonstrated the presence of radioresistant hypoxic cells in experimental cancers. Their work stimulated much clinical and experimental research work on hypoxia in tumors. In subsequent investigations, a marked impact of hemoglobin levels on treatment outcome was found by Evans and Bergsjö in 1965. They found a stage-dependent linear relationship between hemoglobin levels and local control as well as survival after radiotherapy. Evans and Bergsjö interpreted their findings as a result of anemia-induced tumor hypoxia. Although numerous other studies have further supported an association between anemia and decreased local control and survival in radiotherapy patients, some controversies have remained and most radiotherapists did not focus on the prognostic impact of anemia in daily work. The main question over the recent years has concentrated on whether or not the well-known association between anemia and survival reflects a causal relationship or represents only an epiphenomemon (Fyles et al. 2000).


Cervical Cancer Hemoglobin Level Radiation Oncology Prognostic Impact Radiation Therapy Oncology Group 
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© Springer-Verlag/Wien 2002

Authors and Affiliations

  1. 1.Department of Radiation OncologyMartin-Luther-University Halle-WittenbergHalleGermany
  2. 2.Department of Radiation OncologyTechnical University MunichMunichGermany

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