title: Prognostic impact of hemoglobin level prior to radiotherapy on survival in patients with glioblastoma.
abstract: OBJECTIVE
  To evaluate prognostic factors in patients with glioblastoma treated with postoperative or primary radiotherapy.
  
  
  METHODS
  From 1989 to 2000, a total of 100 patients underwent irradiation as part of their initial treatment for glioblastoma. All patients had undergone surgery or biopsy followed by conventional external-beam radiotherapy. 85 patients who received the planned dose of irradiation (60 Gy in 30 fractions) were analyzed for the influence of prognostic factors. 73/85 (86%) of patients were given postoperative irradiation, while 12/85 (14%) of patients were primarily treated with radiotherapy after biopsy.
  
  
  RESULTS
  The median overall survival was 10.1 months (range, 3.7-49.8 months), the 1- and 2-year survival rates were 41% and 5%, respectively. Univariate analysis revealed age < or = 55 years (p < 0.001), pre-radiotherapy hemoglobin (Hb) level > 12 g/dl (p = 0.009), and pre-radiotherapy dose of dexamethasone < or = 2 mg/day (p = 0.005) to be associated with prolonged survival. At multivariate analysis, younger age (p < 0.001), higher Hb level (p = 0.002), lower dose of dexamethasone (p = 0.026), and a hemispheric tumor location (p = 0.019) were identified as independent prognostic factors for longer survival. The median survival for patients with an Hb level > 12 g/dl was 12.1 months compared to 7.9 months for those with a lower Hb level. Contingency-table statistics showed no significant differences for the two Hb groups in the distribution of other prognostic factors.
  
  
  CONCLUSIONS
  The results indicate that lower Hb level prior to radiotherapy for glioblastoma can adversely influence prognosis. This finding deserves further evaluation.
authors: Department of Oncology and Radiotherapy, Charles University Hospital, Hradec Kralove, Czech Republic. odrazka@fnhk.cz
authors: Karel
authors: K
authors: Odrazka
authors: Jiri
authors: J
authors: Petera
authors: Tereza
authors: T
authors: Kohlova
authors: Martin
authors: M
authors: Dolezel
authors: Miloslava
authors: M
authors: Vaculikova
authors: Milan
authors: M
authors: Zouhar
authors: Vaclav
authors: V
authors: Malek
authors: Vladimir
authors: V
authors: Hobza
authors: Ivan
authors: I
authors: Latr
authors: Stanislav
authors: S
authors: Nemecek
authors: Miroslav
authors: M
authors: Sercl
authors: Pavel
authors: P
authors: Ryska
authors: Milan
authors: M
authors: Blaha
authors: Eva
authors: E
authors: Cermakova
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000097:blood / Q000175:diagnosis / Q000401:mortality* / Q000532:radiotherapy* / Q000601:surgery; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D003907:Dexamethasone / Q000008:administration & dosage; D019583:Dose Fractionation, Radiation; D005260:Female; D005909:Glioblastoma / Q000097:blood / Q000175:diagnosis / Q000401:mortality* / Q000532:radiotherapy* / Q000601:surgery; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D000893:Anti-Inflammatory Agents; D018931:Antineoplastic Agents, Hormonal; D006454:Hemoglobins; D003907:Dexamethasone