[Effects of anemia and hypoxia on the course of tumors and the outcome of radiotherapy].
This paper will present an overview of the evidence that links anemia with a poor prognosis in a variety of human tumors treated with radiation, surgery, chemotherapy or combinations thereof. Hypoxia, acute or chronic in type, is also associated with a poor prognosis, mediated through two possible routes: 1) resistance to therapy with radiation or chemotherapy, and 2) the development of a more "aggressive" tumor phenotype. While anemia and hypoxia are related to some degree in some patients, it is probable that not all of the associated negative impact of anemia is translated through the hypoxia pathway. Because of the clinical importance and essential role hypoxia plays in tumor growth and treatment response, hypoxia and anemia are possible key targets for new therapies. The identified downstream molecular events resulting in increased glycolysis, erythropoiesis and angiogenesis form specific pathways which offer targets for inhibition. The relationship between anemia and hypoxia is complex and not clearly understood. Their relationships and the mechanisms by which they impact on treatment outcomes require further extensive investigations in both the clinic and laboratory.
Thomas
G M
GM
Departments of Radiation Oncology and Obstetrics and Gynecology, University of Toronto.
D000740:Anemia / Q000150:complications*; D006801:Humans; D000860:Hypoxia / Q000150:complications*; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy*
Effetti di anemia e ipossia sull'evoluzione del tumore e sui risultati della terapia radiante.