Oxygenation of human tumors--implications for combined therapy.

Recent studies show that the presence of hypoxia is associated with poor local control and overall survival in patients with cervical cancer and head and neck cancer. An indirect support for the influence of hypoxia on radiation response is derived from observations of a correlation between tumor control and hemoglobin level. Most of the clinical studies have shown better tumor control in patients with higher hemoglobin levels than in patients with levels below normal range due to tumor associated or therapy-induced anemia. The problem of chemotherapy induced anemia is particularly of clinical relevance in patients with lung cancer. This manuscript reviews the clinical investigations in patients with lung cancer which have been performed with regard to improve tumor oxygenation increasing the amount of hemoglobin available to transport oxygen.