title: Pre-treatment anaemia alters outcome in early squamous cell carcinoma of the larynx treated by radical radiotherapy.
abstract: The purpose of this study was to examine the effect of pre-treatment anaemia on tumour recurrence and survival in patients treated with primary radiotherapy for early squamous cell carcinoma of the larynx. A retrospective analysis of 117 patients with previously untreated T1N0M0 and T2N0M0 squamous cell carcinoma of the larynx was carried out. Patients were considered anaemic if their pre-treatment haemoglobin levels were below 13 g/dl in males and 11.5 g/dl in females. The influence of pre-treatment haemoglobin levels on local control and survival were evaluated using Cox proportional hazards regression models. Two- and five-year local-regional control estimates for anaemic patients were 58 per cent and 53 per cent respectively while patients with normal haemoglobin levels had two and five-year local-regional control rates of 90 per cent and 81 per cent respectively (p = 0.002). Multivariate Cox regression analysis showed pre-treatment haemoglobin significantly influencing recurrence-free survival (p = 0.0094). Patients with a low haemoglobin level prior to radiation therapy suffered higher levels of local-regional failure.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Aberdeen Royal Infirmary, UK.
authors.forename: D G
authors.initials: DG
authors.lastname: Grant
authors.forename: A
authors.initials: A
authors.lastname: Hussain
authors.forename: D
authors.initials: D
authors.lastname: Hurman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications* / Q000401:mortality; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000150:complications* / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome