Prevalence and significance of anaemia in patients receiving long-course neoadjuvant chemoradiotherapy for rectal carcinoma
Version of Record online: 20 DEC 2012
© 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland
Volume 15, Issue 1, pages 52–56, January 2013
How to Cite
Walter, C. J., Bell, L. T. O., Parsons, S. R., Jackson, C., Borley, N. R. and Wheeler, J. M. D. (2013), Prevalence and significance of anaemia in patients receiving long-course neoadjuvant chemoradiotherapy for rectal carcinoma. Colorectal Disease, 15: 52–56. doi: 10.1111/j.1463-1318.2012.03112.x
- Issue online: 20 DEC 2012
- Version of Record online: 20 DEC 2012
- Accepted manuscript online: 29 MAY 2012 10:12AM EST
- Received 14 January 2012; accepted 15 April 2012; Accepted Article online 29 May 2012
- Rectal cancer;
- neoadjuvant chemoradiotherapy;
Aim The study aimed to assess the prevalence and significance of anaemia during long-course neoadjuvant radiotherapy for rectal cancer at our centre.
Method Hospital coding and a prospective oncology database were used to identify all patients undergoing long-course neoadjuvant radiotherapy for rectal cancer at our centre between 2004 and 2009. A retrospective review of computerized records was used to extract individual patient data. Anaemia was defined as a haemoglobin level of < 11.5 g/dl for women and of < 13 g/dl for men. Downstaging was assessed by comparing radiological stage (rTNM) with histological stage (ypTNM). Tumour regression after radiotherapy was assessed using the Rectal Cancer Regression Group (RCRG) scores of 1–3. The results were analysed using Gnu PSPP statistical software.
Results There were 70 patients (51 men) of median age 66 (interquartile range 60–72.75) years. Of these, 24 were anaemic. Two (3%) had no haemoglobin level recorded and were excluded. Forty-two per cent of anaemic patients demonstrated mural (T) downstaging compared with 68% of nonanaemic patients (P = 0.03). There was no difference in nodal downstaging between the groups. The RCRG scores showed more tumour regression in nonanaemic patients than in anaemic patients, as follows: RCRG 1, 59%vs 30%; RCRG 2, 11%vs 17%; and RCRG 3, 38%vs 46% (P < 0.001).
Conclusion The prevalence of anaemia in patients undergoing long-course neoadjuvant radiotherapy was 35%. Anaemia during long-course neoadjuvant radiotherapy was associated with significant reductions in tumour downstaging and regression.