WHAT IS THE IMPORTANCE OF ANEMIA IN RADIOTHERAPY - THE VALUE OF ANIMAL STUDIES
WHAT IS THE IMPORTANCE OF ANEMIA IN RADIOTHERAPY - THE VALUE OF ANIMAL STUDIES
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DOI：
10.1016/0167-8140(91)90183-h
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发表时间：
1991-01-01
影响因子：
5.7
通讯作者：
HIRST, DG
中科院分区：
文献类型：
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作者：
HIRST, DG
多年来，人们已经认识到贫血性癌症患者的预后特别差（见最近的综述[4，8]）。 新的数据经常出现在文献中，扩展了我们的知识，包括许多肿瘤部位。 现在的证据是压倒性的，对于大多数这些，局部肿瘤控制放疗是妥协的患者贫血之前和期间放疗。放射生物学家的作用必须是对临床观察结果作出解释，并提出一种方法，以补偿那些因贫血而受到治疗影响的病人的问题。 这种说法假设贫血和肿瘤可治愈性之间存在因果关系，推测是通过损害氧气运输到肿瘤细胞。 然后，我们必须考虑动物模型肿瘤系统中循环血红蛋白水平降低的后果，将这些信息与我们对生理机制的了解联合收割机结合起来，并试图使我们的结论与临床发现相一致。 当然，我们应该意识到，未能实现这一点可能是由于小鼠模型的不足，或者因为贫血根本不是临床辐射抗性的原因，而是一个后果，沿着特定肿瘤特征的辐射敏感性。实验动物数据揭示了什么？ 我们将考虑两个临床上重要的问题：1）血红蛋白水平低于正常水平的小鼠肿瘤是否对辐射更具抵抗力，以及贫血持续时间与敏感性之间的时间关系是什么？ 2)放射治疗前血红蛋白水平的恢复是否会改变敏感性？
It has been recognised for many years that anaemic cancer patients have a particularly poor prognosis (see recent reviews [4,8]). New data is regularly appearing in the literature, extending our knowledge to include many tumor sites. The evidence is now overwhelming that for most of these, local tumor control by radiotherapy is compromised in patients who are anaemic before and during radiotherapy. The role of the radiobiologist must be to offer an explanation for the clinical observations and to suggest a means of compensating for the problem in those patients whose treatment is prejudiced by anaemia. This statement assumes a cause and effect relationship between anaemia and tumor curability, supposedly through an impairment of oxygen transport to the tumor cells. We must then consider the consequences of a reduction in circulating haemoglobin levels in model tumor systems in animals, combine that information with our knowledge of physiological mechanisms and attempt to reconcile our conclusions with the clinical findings. We should be aware of course, that a failure to achieve this could be the result of inadequacies of the mouse model or because anaemia is simply not the cause of clinical radioresistance but rather a consequence, along with radiosensitivity of particular tumor characteristics.What do the experimental animal data reveal? We will consider two clinically important questions: 1) Are tumors in mice with lower than normal haemoglobin levels more resistant to radiation and what is the temporal relationship between duration of anaemia and sensitivity? 2) Does the restoration of haemoglobin levels before radiotherapy change sensitivity?