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dc.contributor.authorWelsh, L
dc.contributor.authorPanek, R
dc.contributor.authorRiddell, A
dc.contributor.authorWong, K
dc.contributor.authorLeach, MO
dc.contributor.authorTavassoli, M
dc.contributor.authorRahman, D
dc.contributor.authorSchmidt, M
dc.contributor.authorHurley, T
dc.contributor.authorGrove, L
dc.contributor.authorRichards, T
dc.contributor.authorKoh, D-M
dc.contributor.authorNutting, C
dc.contributor.authorHarrington, K
dc.contributor.authorNewbold, K
dc.contributor.authorBhide, S
dc.date.accessioned2017-01-03T12:19:25Z
dc.date.issued2017-01-03
dc.identifier.citationBritish journal of cancer, 2017, 116 (1), pp. 28 - 35
dc.identifier.issn0007-0920
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/356
dc.identifier.eissn1532-1827
dc.identifier.doi10.1038/bjc.2016.386
dc.description.abstractBACKGROUND: Patients with head and neck squamous cell carcinoma (HNSCC) undergoing radical chemo-radiation (CRT) frequently receive transfusion with packed red cells (PRCT) during radiotherapy on the basis that PRCT increases tumour oxygenation and overcomes hypoxia-induced radio-resistance. This is likely to be a significant oversimplification given the fact that tumour hypoxia is the result of several intrinsic and extrinsic factors, including many that are not directly related to serum haemoglobin (Hb). Therefore, we have studied the effect of PRCT on tumour oxygenation in a prospective cohort of patients who developed low Hb during radical CRT for HNSCC. METHODS: This was a prospective study of 20 patients with HNSCC receiving radical CRT undergoing PRCT for Hb<11.5 g dl-1. Patients underwent pretransfusion and posttransfusion intrinsic susceptibility-weighted (SWI) MRI and dynamic contrast-enhanced (DCE) MRI. Blood samples were obtained at the time of MRI scanning and two further time points for measuring Hb and a panel of serum cytokine markers of tumour hypoxia. 3D T2* and Ktrans maps were calculated from the MRI data for primary tumours and cervical lymph node metastases. RESULTS: PRCT produced no change (11 patients) or reduced (1 patient) T2* (tumour oxygenation) in 12 of the 16 (75%) evaluable primary tumours. Three of the four patients with improved tumour oxygenation progressed or had partial response following treatment completion. There were variable changes in Ktrans (tumour perfusion or vessel permeability) following PRCT that were of small magnitude for most tumours. Pre- and Post-PRCT levels of measured cytokines were not significantly different. CONCLUSIONS: This study suggests that PRCT during radical CRT for HNSCC does not improve tumour oxygenation. Therefore, oncologists should consider changing practice according to NICE and American Association of Blood Banks guidelines on PRCT for anaemia.
dc.formatPrint-Electronic
dc.format.extent28 - 35
dc.languageeng
dc.language.isoeng
dc.publisherNATURE PUBLISHING GROUP
dc.rights.urihttps://creativecommons.org/licenses/by-nc-sa/4.0
dc.subjectHumans
dc.subjectCarcinoma, Squamous Cell
dc.subjectHead and Neck Neoplasms
dc.subjectLymphatic Metastasis
dc.subjectMagnetic Resonance Imaging
dc.subjectBlood Transfusion
dc.subjectLongitudinal Studies
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectChemoradiotherapy
dc.subjectTumor Hypoxia
dc.subjectSquamous Cell Carcinoma of Head and Neck
dc.titleBlood transfusion during radical chemo-radiotherapy does not reduce tumour hypoxia in squamous cell cancer of the head and neck.
dc.typeJournal Article
dcterms.dateAccepted2016-10-25
rioxxterms.versionofrecord10.1038/bjc.2016.386
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc-sa/4.0
rioxxterms.licenseref.startdate2017-01
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfBritish journal of cancer
pubs.issue1
pubs.notes12 months
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology/Targeted Therapy
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Magnetic Resonance
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Targeted Therapy
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology/Targeted Therapy
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Magnetic Resonance
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Targeted Therapy
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume116
pubs.embargo.terms12 months
icr.researchteamMagnetic Resonance
icr.researchteamTargeted Therapy
dc.contributor.icrauthorLeach, Martin
dc.contributor.icrauthorHarrington, Kevin
dc.contributor.icrauthorBhide, Shreerang


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