Prognostic significance of pretreatment hemoglobin for local control and overall survival in T1-T2N0 larynx cancer treated with external beam radiotherapy.

Abstract

PURPOSE:

To elucidate a relationship between pretreatment hemoglobin and local control in patients with T1-T2N0 larynx cancer treated with radiotherapy.

METHODS AND MATERIALS:

A total of 246 patients with T1-T2N0 cancer of the larynx were included in this analysis. Patients were treated using a median daily fraction of 200 cGy to a total median dose of 66 Gy within 47 days. Prognostic factors included pretreatment hemoglobin, age, gender, race, T stage, tumor subsite, beam energy, biologically equivalent dose, and therapy duration.

RESULTS:

Fifty patients developed local relapse, for an actuarial 5-year relapse-free rate of 77.3%. The actuarial 5-year survival rate was 69.8%. The pretreatment hemoglobin levels were assessed using the following hemoglobin quartiles: 10.1-13.3, 13.4-14.1, 14.2-14.9, and 15.0-18.3 g/dL. On Cox multivariate analysis, the pretreatment hemoglobin level predicted for local failure and poorer overall survival. The relative risk for 5-year local relapse by hemoglobin quartile was 2.70, 2.33, 1.91, and 1.00 (p = 0.034). The relative risk for poorer 5-year overall survival by hemoglobin quartile was 2.23 1.30, 0.80, and 1.00 (p <0.001).

CONCLUSION:

Pretreatment hemoglobin levels predicted for local control and overall survival for larynx cancer in a multivariate model. This relationship has potential therapeutic implications regarding correcting anemia before the initiation of radiotherapy for optimal outcome.

• Authors: Edward I Cho, Clarence T Sasaki, Bruce G Haffty
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 58 Issue 4 Pg. 1135-40 (Mar 15 2004) ISSN: 0360-3016 [Print] United States
• PMID: 15001255 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Biomarkers
• Hemoglobin A

Topics

• Adult
• Aged
• Aged, 80 and over
• Analysis of Variance
• Biomarkers (analysis)
• Carcinoma, Squamous Cell (blood, pathology, radiotherapy)
• Follow-Up Studies
• Hemoglobin A (analysis)
• Humans
• Laryngeal Neoplasms (blood, pathology, radiotherapy)
• Middle Aged
• Neoplasm Recurrence, Local
• Prognosis
• Radiotherapy Dosage