Almost one
cancer patient in two is anemic, with a correspondingly poorer prognosis and quality of life. A low blood
hemoglobin level seems to directly impair treatment efficacy, particularly of
radiotherapy, possibly because low tissue oxygenation causes a decrease in radiosensitivity. Tissue
hypoxia may also facilitate
tumor progression and impair the efficacy of
cytostatic drugs. This constitutes a powerful rationale for correcting
cancer anemia. Red cell transfusion is immediately effective, but carries risks of
infection and immunosuppression. A safer alternative is recombinant human
erythropoietin (rhEPO), which has already proved feasible and effective in correcting
anemia and improving quality of life of
cancer patients. Several ongoing
radiotherapy studies are presently investigating whether rhEPO conclusively increases
cancer cure rates. First results should be available in 2001. Given the efficacy of rhEPO to stimulate erythropoiesis and improve quality of life of
cancer patients and its potential to enhance radiation's efficacy seem to earn it a firm place at least in the radiooncologist's arsenal.