title: Influence of anaemia in patients with head and neck cancer receiving adjuvant postoperative radiotherapy in the Grampian region.
abstract: OBJECTIVE
  To assess the impact of haemoglobin on local recurrence and overall survival in patients receiving postoperative radiotherapy for squamous cell carcinoma of the head and neck.
  
  
  METHODS
  A retrospective study identified all patients with head and neck carcinoma treated with primary surgery followed by adjuvant radiotherapy from 1994-2000. Data were collected on host-related, tumour-related and treatment-related factors, and outcome was measured in terms of time to local recurrence and overall survival.
  
  
  RESULTS
  Ninety-five patients were identified for analysis. The median age was 58.5 years; 31% were women. Mean pre-treatment haemoglobin was 128 g/l. The primary site of tumour was in the oral cavity in 35% of patients, oropharynx in 20%, larynx in 20% and hypopharynx in 5% of patients. Nodal involvement was seen in 48% of patients. A median biologically effective dose (BED) of 62.5 Gy10 was delivered, with a median overall treatment time of 26 days. After a median follow-up of 3.1 years, 23% of patients had local recurrence and 48% had died, with an estimated median survival time of 5.6 years. Actuarial 2-year and 5-year local control rates were both 75%, and actuarial 2-year and 5-year survival rates were 67% and 51%, respectively. Multivariate analysis revealed T stage, margin status, BED and anaemia to be independent prognostic factors, and T stage, N stage, tumour site, BED and anaemia to be independent predictors for local recurrence.
  
  
  CONCLUSIONS
  The data from this study are consistent with the hypothesis that pre-treatment anaemia is an independent prognostic factor for survival and predictive factor for local recurrence in postoperative radiotherapy for head and neck cancer.
authors.affiliation: Department of Clinical Oncology, Aberdeen Royal Infirmary, Grampian, Scotland, UK. GMacDonald@bccancer.bc.ca
authors.forename: G
authors.initials: G
authors.lastname: Macdonald
authors.forename: D C
authors.initials: DC
authors.lastname: Hurman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications* / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D012606:Scotland; D016019:Survival Analysis