Advertisement

Relationship between anemia and tumor hypoxia

  • Jürgen Dunst
  • M. Molls

Abstract

Hypoxia is a major and independent prognostic factor in solid cancers. Tissue hypoxia in tumors and normal tissue develops if the oxygen supply cannot satisfy the oxygen demand (Vaupel et al. 1989). The complex pathophysiological mechanisms have recently been reviewed (Höckel and Vaupel 2001). Hypoxia seems to represent a general pathophysiological phenomenon in solid cancers and is associated with more rapid malignant progression and poor prognosis (Höckel et al. 1996; Höckel and Vaupel 2001).

Keywords

Cervical Cancer Uterine Cervix Tumor Hypoxia Anemic Patient Recombinant Human Erythropoietin 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Antonadou A, Cadarmakis E, Sarris G, Tzigounis T (1998) Effect of the administration of recombinant human erythropoietin in patients with pelvic malignancies during radiotherapy. Radiother Oncol 48 (Suppl 1): S122Google Scholar
  2. Bush RS (1986) The significance of anemia in clinical radiation therapy. Int J Radiat Oncol Biol Phys 12: 2047–2050 124 J. Dunst and M. MollsGoogle Scholar
  3. Becker A, Stadler P, Lavey R, Haensgen G, Kuhnt T, Lautenschlaeger C, Feldmann HJ, Molls M, Dunst J (2000) Severe anemia is associated with poor tumor oxygenation in head and neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys 46: 459–466PubMedCrossRefGoogle Scholar
  4. Brizel DM, Scully SP, Harrelson JM, Layfield LJ, Bean JM, Prosnitz LR, Dewhirst MW (1996) Tumor oxygenation predicts for the likelihood of distant metastases in human soft tissue sarcoma. Cancer Res 56: 941–943PubMedGoogle Scholar
  5. Feldmann HJ, Sievers K, Füller J, Molls M, Löhr E (1993) Evaluation of tumor blood perfusion by dynamic MRI and CT in patients undergoing thermoradiotherapy. Eur J Radiol 16: 224–229PubMedCrossRefGoogle Scholar
  6. Feldmann HJ, Molls M, Vaupel P (1999) Blood flow and oxygenation status of human tumors. Clinical investigation. Strahlenther Onkol 175: 1–9Google Scholar
  7. Fyles AW, Milosevic M, Pintilie M, Syed A, Hill RP (1998) Cervix cancer oxygenation measured following external radiation therapy. Int J Radiat Oncol Biol Phys 42: 751–753PubMedCrossRefGoogle Scholar
  8. Fyles AW, Milosevic M, Pintilie M, Syed A, Hill RP (2000) Anemia, hypoxia and transfusion in patients with cervical cancer: a review. Radiother Oncol 57: 13–19PubMedCrossRefGoogle Scholar
  9. Hoeckel M, Knoop C, Schlenger K, Vorndran B, Baussmann E, Mitze M, Knapstein PG, Vaupel P (1993) Intratumoral pO2 predicts survival in advanced cancer of the uterine cervix. Radiother Oncol 26: 45–50CrossRefGoogle Scholar
  10. Höckel M, Schlenger K, Aral B, Mitze M, Schaffer U, Vaupel P (1996) Association between tumor hypoxia and malignant progression in advanced cancer of the uterine cervix. Cancer Res 56: 4509–4515PubMedGoogle Scholar
  11. Höckel M, Vaupel P (2001) Tumor hypoxia: definitions and current clinical, biological, and molecular aspects. J Natl Cancer Inst 93: 266–267PubMedCrossRefGoogle Scholar
  12. Kelleher DK, Matthiensen U, Thews O, Vaupel P (1995) Tumor oxygenation in anemic rats: effects of erythropoietin treatment versus red blood cell transfusion. Acta Oncol 34: 379–384PubMedCrossRefGoogle Scholar
  13. Kelleher DK, Matthiensen U, Thews O, Vaupel P (1996) Blood flow, oxygenation and bioenergetic status of tumors after erythropoietin treatment in normal and anemic rats. Cancer Res 56: 4728–4734PubMedGoogle Scholar
  14. Kelleher DK, Höckel M, Vaupel P (2001) (yet unpublished)Google Scholar
  15. Knocke TH, Weitmann HD, Feldmann HJ (1999) Intratumoral pO2-measurements as predictive assay in the treatment of carcinoma of the uterine cervix. Radiother Oncol 53: 99–104PubMedCrossRefGoogle Scholar
  16. Koh WJ, Rasey JS, Evans ML, Grierson JR, Lewellen TK, Graham MM, Krohn KA, Griffin TW (1992) Imaging of hypoxia in human tumors with F-18fluoromisonidazole. Int J Radiat Oncol Biol Phys 22: 199–212PubMedCrossRefGoogle Scholar
  17. Kumar P (2000) Tumor hypoxia and anemia: impact on the efficacy of radiation therapy. Semin Hematol 37 (Suppl 6): 4–8PubMedCrossRefGoogle Scholar
  18. Mayr NA, Yuh WT, Arnholt JC, Ehrhardt JC, Sorosky JL, Magnotta VA, Berbaum KS, Zhen W, Paulino AC, Oberley LW, Sood AK, Buatti JM (2000) Pixel analysis of MR perfusion imaging in predicting radiation therapy outcome in cervical cancer. J Magn Reson Imaging 12: 1027–1033PubMedCrossRefGoogle Scholar
  19. Molls M, Vaupel P (eds) (2000) Blood perfusion and microenvironment of human tumors. Implications for clinical radiooncology. Springer, Heidelberg, ISBN 3540–58866–3 (Soft cover version)Google Scholar
  20. Mueller-Klieser W, Vaupel P, Manz R, Schmidseder R (1981) Intracapillary oxyhemoglobin saturation in malignant tumors in humans. Int J Radiat Oncol Biol Phys 7: 1397–1404PubMedCrossRefGoogle Scholar
  21. Nordsmark M, Overgaard M, Overgaard J (1996) Pretreatment oxygenation predicts radiation response in advanced squamous cell carcinoma of the head and neck. Radiother Oncol 41: 31–39PubMedGoogle Scholar
  22. Olive P (1995) Use of the comet-assay to detect hypoxic cells in murine tumors and normal tissues exposed to bioreductive drugs. Acta Oncol 34: 301–305PubMedCrossRefGoogle Scholar
  23. Overgaard J, Horsman MR (1996) Modification of hypoxia-induced radioresistance in tumors by the use of oxygen and sensitizers. Semin Radiat Oncol 6: 10–21PubMedCrossRefGoogle Scholar
  24. Rijken PF, Bernsen HJ, Peters JP, Hodgkiss RJ, Raleigh JA, van der Kogel AJ (2000) Spatial relationship between hypoxia and the (perfused) vascular network in a human glioma xenograft: a quantitative multi-parameter analysis. Int J Radiat Oncol Biol Phys 48: 571–582PubMedCrossRefGoogle Scholar
  25. Rofstad EK, Sundfor K, Lyng H, Troppe CG (2000) Hypoxia-induced treatment failure in advanced squamous cell carcinoma of the uterine cervix is primarily due to hypoxia-induced radiation resistance rather than hypoxia-induced metastasis. Br J Cancer 83: 354–359PubMedCrossRefGoogle Scholar
  26. Rudat V, Becker A, Stadler P (2001) Low predicitive value of p02-histography in head and neck cancers. Int J Radiat Oncol Biol Phys (submitted)Google Scholar
  27. Stadler P, Becker A, Feldmann HJ, Dunst J, Molls M (1999) Influence of the hypoxic subvolume on the survival of patients with head and neck cancer. Int J Radiat Oncol Biol Phys 44: 749–754PubMedCrossRefGoogle Scholar
  28. Sundfor K, Lyng H, Rofstad EK (1998) Tumor hypoxia and vascular density as predictors of metastasis in squamous cell carcinoma of the uterine cervix. Br J Cancer 78: 822–827PubMedCrossRefGoogle Scholar
  29. Thews O, König R, Kelleher DK, Kutzner J, Vaupel P (1998) Enhanced radio-sensitivity in experimental tumours following erythropoietin treatment of chemotherapy-induced anaemia. Br J Cancer 78: 752–766PubMedCrossRefGoogle Scholar
  30. Thews O, Kelleher DK, Vaupel P (2001) Erythropoietin restores the anemia-induced reduction in cyclophosphamide cytotoxicity in rat tumors. Cancer Res 61: 1358–1361PubMedGoogle Scholar
  31. Vaupel P, Kallinowski F, Okunieff P (1989) Blood flow, oxygen and nutrient supply, and metabolic environment of human tumors: a review. Cancer Res 49: 6449–6465PubMedGoogle Scholar
  32. Vaupel P, Kelleher DK, Thews 0 (1998) Modulation of tumor oxygenation. Int J Radiat Oncol Biol Phys 42: 843–848CrossRefGoogle Scholar
  33. Yamashita Y, Baba B, Baba Y, Nishimura R, Ikeda S, Takahashi M, Ohtake H, Okamura H (2000) Dynamic contrast-enhanced MR imaging of uterine cervical cancers: pharmacokinetic analysis with histopathological correlations and its importance in predicting the outcome of radiation therapy. Radiology 216: 803–809PubMedGoogle Scholar

Copyright information

© 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

Personalised recommendations