[Does the initial hemoglobin value modify the primary tumor reaction? A study of 264 irradiated bronchial cancers].

Abstract

In a retrospective investigation the remission rate was determined in roentgen picture for 264 male patients with bronchogenic carcinoma after intensive radiotherapy (target dose 56 Gy). Classification of roentgenologic remission was done in 3 groups (complete, partial, minimal/no remission). For each patient the pretherapeutic haemoglobin value was taken from casebook and clinical relevant limit concentrations for an anaemia were correlated with the classified remissions. The difference of regression frequency between complete and partial remission always can be secured statistically irrespectively of chosen limit, that is the anaemia has a provable influence on roentgenologic tumor reaction. To prove that the tumor value as a third variable is not responsible for that a covariant analysis was done. According to that the corrected mean haemoglobin values were 8.9 mmol/l for complete, 8.1 mmol/l for partial and 7.7 mmol/l for minimal/no remission. These differences of the mean values are significant in Newman-Keuls-test, the relation between initial haemoglobin value and remission type is provable independently of tumor volume. Also for bronchogenic carcinoma with that a dependence could be shown between haemoglobin concentration--and by this the oxygen supply of the tumor--and the reaction of the primary tumor after radiotherapy. From this we deduce the recommendation to treat anaemia before beginning of radiotherapy or to irradiate anaemic patients applying an effective sensitizer.