Effect of Pretreatment Anemia on Treatment Outcome of Concurrent Radiochemotherapy in Patients With Head and Neck Cancer
Received 21 March 2008; received in revised form 26 April 2008; accepted 30 April 2008. published online 15 July 2008.
Purpose
To investigate the effect of anemia on outcome of treatment with radiochemotherapy in patients with head-and-neck cancer.
Methods and Materials
The data of 196 patients with Stage II-IV head-and-neck cancer treated with concomitant cisplatin-based radiochemotherapy were retrospectively reviewed. Anemia was defined according to World Health Organization criteria as hemoglobin <130 g/L in men and <120 g/L in women.
Results
Fifty-three patients were classified as anemic, 143 as nonanemic. The 3-year local control rate of anemic and nonanemic patients was 72% and 85%, respectively (p = 0.01). The 3-year overall survival rate of anemic and nonanemic patients was 52% and 77%, respectively (p = 0.004). In multivariate analysis, anemia was the most significant predictor of local control (hazard ratio, 0.37, p = 0.009) and survival (hazard ratio, 0.47, p = 0.007). A dose–effect relationship was also found for local control (p = .04) and survival (0.04) when grouping by hemoglobin concentration: <120, 120–140, and >140 g/L.
Conclusions
Anemia was strongly associated with local control and survival in this cohort of patients with head-and-neck cancer receiving radiochemotherapy.
∗Department of Radiation Oncology, L'Hôtel-Dieu de Québec, Québec, Canada
Reprint requests to: André Fortin, M.D., M.Sc., Department of Radiation Oncology, CHUQ, L'Hotel-Dieu de Québec, 11 Côte du Palais, Québec, Québec, Canada G1R 2J6. Tel: (418) 691-5264, Fax: (418) 691-5268
ABSTRACT