Blood Flow In Cervical Tumors Can Predict Outcome

Measuring both the level of red blood cells in the body and the blood flow in tumors can help predict which cervical cancer patients are likely to have a better outcome, according to researchers at the Ohio State University Comprehensive Cancer Center.

"We must look at how the oxygenation in the circulation and the vasculature of each individual tumor interact," says Dr. Nina Mayr, a researcher and chair of radiation medicine at the James Cancer Hospital and Solove Research Institute at Ohio State University. "For cancer therapy to be effective, tumors must have blood flow and sufficient oxygen."

Mayr presented the findings recently during the annual meeting of the American Society of Therapeutic Radiology and Oncology in Los Angeles.

"We have identified a method using magnetic resonance imaging (MRI) to check the actual blood flow within tumors as they are treated. If we put together both the number of red blood cells that a patient's body has to carry the oxygen to the tumor, and the blood flow within the tumor, we have a powerful predictor to tell us whether the treatment will work," says Mayr.

Researchers analyzed the levels of red blood cells throughout the course of radiation and chemotherapy in 66 cervical cancer patients. In addition, they examined the blood supply of the tumor during therapy in each patient using innovative MRI techniques.

The level of red blood cells has long been thought to influence the response of tumors to radiation therapy and chemotherapy. Red blood cells contain hemoglobin, which carries the oxygen from the lungs to the tissue. Low red blood cell levels have been implicated in poor treatment response in cervical cancer patients - probably due to poor oxygen supply, which impairs the tumor-killing effects of radiation, Mayr says.

"We found that we must analyze both the level of red blood cells and the vasculature 'signature' of each individual tumor," Mayr says. "If both are high, patients responded well to therapy and had a 91 percent chance of survival. But when both are low, patients had a 32 percent chance of tumor recurrence, and only a 56 percent chance of survival."

Patients often receive transfusions or stimulating factors that boost their low red blood cell levels, but those treatments can be expensive, uncomfortable and somewhat risky, says Mayr, also holder of the Max Morehouse Chair in Cancer Research at Ohio State.

"Now we may have a way to predict whether that treatment will work for each individual patient," Mayr says. "This new information may help to make cancer care more personalized by using transfusions in patients who need them most, and we may be able to avoid them in those who will do well without them."