The role of hemoglobin concentration in clinically localized prostate cancer treated with radical radiotherapy +/- neoadjuvant androgen deprivation.
OBJECTIVE
Serum hemoglobin level (Hb) is a significant determinant of treatment outcome after radical radiotherapy (RT) for several cancer types, but its importance in prostate cancer is not well established.


METHODS
Two treatment-specific cohorts of men with localized prostate cancer (T1-4, Nx/N0, M0) were analyzed. Seven hundred six men who received radical RT at Princess Margaret Hospital between 1987 and 2000 comprise the RT-alone cohort, of whom 536 had a pre-RT Hb. Six hundred fifty-eight men received 3-6 months' neoadjuvant androgen deprivation (NAD) and radical RT at Royal Marsden Hospital between 1989 and 2000 and comprise the NAD + RT cohort, of whom 475 had a pre-NAD Hb and 513 a pre-RT Hb. Time to biochemical failure (TTBF) was the primary end point. Univariate and multivariate analyses using the Cox proportional hazards regression model were used for each data set independently to study the prognostic role of pre-RT Hb, pre-NAD Hb, nadir Hb (lowest Hb during RT), Hb decrement (pre-NAD Hb - pre-RT Hb), Gleason score, presenting PSA, and T stage.


RESULTS
On univariate analysis, no significant association was seen between TTBF and any of the Hb variables for either data set. On multivariate analysis, TTBF was associated with presenting PSA (p < 0.001), Gleason score (p < 0.01), and (for the NAD + RT data set) T stage (p < 0.001), but not pre-NAD Hb (p = 0.24) or pre-RT Hb (p > 0.3).


CONCLUSIONS
Hemoglobin level is not an important determinant of RT outcome in localized prostate cancer.
Parker
Chris
C
Academic Unit of Radiotherapy and Oncology, Institute of Cancer Research and The Royal Marsden NHS Trust, Sutton, Surrey, United Kingdom.
Warde
Padraig
P
Norman
Andy
A
Panzarella
Tony
T
Catton
Charles
C
Horwich
Alan
A
Huddart
Robert
R
Dearnaley
David
D
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006441:Hemoglobin A / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D015415:Biomarkers; D006441:Hemoglobin A; D017430:Prostate-Specific Antigen