Hematological Toxicity in Lung Cancer

Part of the Medical Radiology book series (MEDRAD)


The toxicity of tumor cells after chemo and radiotherapy, administered either alone or in combination is dose-dependent. Aggression to the bone marrow, which is expressed by a reduction in circulating blood cells, is often the main dose-limiting toxicity because of the risks of anemia, bleeding, and infection. Prophylactic treatment with granulocyte-colony stimulating factors (G-CSFs) is available to reduce the risk of chemotherapy-induced neutropenia. In 2005, a European Guidelines Working Party was set up by the European Organization for Research and Treatment of Cancer (EORTC) to systematically review the data published on the appropriate use of G-CSF in adult patients receiving chemotherapy. An update of this review was published in 2010. The ASCO has made evidence level II recommendations concerning the treatment of anemia with r-Hu-EPO. For patients with chemotherapy-associated anemia the Committee continues to recommend the implementation of an erythropoiesis-stimulating agent (ESA) when hemoglobin (Hb) values approach or fall below 10 g/dL, to increase Hb values and decrease transfusions. An individual patient data-analysis has shown that ESA increase the mortality in all patients with cancer, and a similar increase might exist in patients on chemotherapy. Finally, only a few trials have examined indications for ESA similar to the indications approved by the Food and Drug Administration.


Febrile Neutropenia Hematologic Toxicity Bone Marrow Toxicity Hyperfractionated Radiotherapy Febrile Neutropenia Risk 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • Francesc Casas
    • 1
  • Ferran Ferrer
    • 2
  • Núria Viñolas
    • 3
  1. 1.Radiation Oncology DepartmentHospital Clínic i UniversitariBarcelonaSpain
  2. 2.Radiation Oncology DepartmentInstitut Català d’OncologiaBellvitgeSpain
  3. 3.Medical Oncology DepartmentHospital Clínic i UniversitariBarcelonaSpain

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