HUBUNGAN KADAR HEMOGLOBIN DENGAN RESPON TUMOR PADA PASIEN KANKER SERVIKS YANG MENDAPAT TERAPI RADIASI DI RSUP DR. SARDJITO

Background: Cervical cancer is the second most common cancer in women worldwide. Radiation therapy is one of the recommended therapies for cervical cancer. But its side effects can suppress bone marrow which decreases hemoglobin (Hb) levels. Hemoglobin is a protein in red blood cells that carry oxygen. During radiation therapy, tumor response depends on tissue oxygenation. Objective: To know the association between hemoglobin levels with tumor response after radiation therapy in patients with cervical cancer. Material and Methods: This study was conducted between May 2012 and February 2013 in 30 patients with cervical cancer during radiation therapy. Hemoglobin level and tumor response were taken from medical record retrospectively. Measurement of Hb levels and tumor response was performed 6 times per week for 5 weeks. Tumor response was measured from the length of tumor. This study used RECIST (Response Evaluation Criteria In Solid Tumors) to evaluate tumor response. Result: During the 5 weeks of therapy, the lowest nadir Hb level was occurred in the second week and the lowest mean Hb level was occurred in the third week. Sixty percent patients had complete response. Partial response was experienced by 40% patient. Mean hemoglobin levels (< 10.5 g/dL) associated with worsening tumor response in patients underwent radiation therapy for 5 weeks (p = 0.045). Conclusion: There was a significant association between the mean hemoglobin levels with tumor response. In this study, the low mean Hb level during radiation therapy could cause a worsening of tumor response. So, the physicians should maintain Hb level above 10.5 g/dL by iron supplementation, blood transfusion, or recombinant human erythropoietin