THE HEMOGLOBIN LEVELS IN PATIENTS WITH PROSTATE CANCER TREATED BY RADICAL RADIOTHERAPY

Keywords:

Radiotherapy - Prostatic Neoplasms - Anemia

Introduction: According to the World Health Organisation, prostate cancer is the third most common diagnosed malignancy and the World Cancer Research Fund International points out prostate cancer as the second most frequent cancer in men worlwide. Radiotherapy has been an important modality of curative treatment in the management of this neoplasm. The prevalence and impact of cancer associated anemia are not widely known and may be overlooked, the restoration of normal hemoglobin levels in patients undergoing radiotherapy has the potential to improve local tumor control and survival, in addition to considerably improving the patient’s quality of life. Although there is an emerging data about the importance of hemoglobin levels in some cancers, there is little published data on its role in prostate cancer. It is believed that the results and toxicity related to radiotherapy treatment of prostate cancer may be influenced by blood hemoglobin levels. Objective To evaluate hemoglobin levels in patients with prostate cancer before and after radiotherapy treatment. Methods: Longitudinal retrospective study envolving forty patients diagnosed with malignant prostate cancer undergoing external beam radiotherapy. Hemoglobin measurement was performed before radiotherapy and after the end of treatment (20-40 days). The prostate risk groups were stratified in accordance with NCCN. Results: The mean age was 67 years (55-79/ 95%CI 65-69 / SD ± 5.4). According to risk group classification, 4 patients were at low risk (10%), 27 patients at intermediate risk (67.5%) and 9 patients at high risk (22.5%). Patients received an external radiation dose of 70 Gy divided in 28 fractions (moderate hypofractionation). The mean pre-radiotherapy hemoglobin levels were 13.3 g/dL (12-16.5 / 95%CI 13.0-13.6 / SD ± 0.9) and the mean post-radiotherapy hemoglobin levels were 10.4 d/dL (9-13 / 95%CI 10.0-10.7 / SD ± 1.1), with a statistically significant difference, p < 0.0001. Conclusion: This study observed a reduction in serum hemoglobin levels after radiotherapy treatment. The results highligh the need for better monitoring these patients as it may be a correspondence with the effects of the radiotherapy dose and the results of treatment with hemoglobina levels, as it has been established in other types of cancer. Further studies with a longer follow up are needed.