Prognostic significance of pretreatment hemoglobin for local control and overall survival in T1-T2N0 larynx cancer treated with external beam radiotherapy.
OBJECTIVE
To elucidate a relationship between pretreatment hemoglobin and local control in patients with T1-T2N0 larynx cancer treated with radiotherapy.


METHODS
A total of 246 patients with T1-T2N0 cancer of the larynx were included in this analysis. Patients were treated using a median daily fraction of 200 cGy to a total median dose of 66 Gy within 47 days. Prognostic factors included pretreatment hemoglobin, age, gender, race, T stage, tumor subsite, beam energy, biologically equivalent dose, and therapy duration.


RESULTS
Fifty patients developed local relapse, for an actuarial 5-year relapse-free rate of 77.3%. The actuarial 5-year survival rate was 69.8%. The pretreatment hemoglobin levels were assessed using the following hemoglobin quartiles: 10.1-13.3, 13.4-14.1, 14.2-14.9, and 15.0-18.3 g/dL. On Cox multivariate analysis, the pretreatment hemoglobin level predicted for local failure and poorer overall survival. The relative risk for 5-year local relapse by hemoglobin quartile was 2.70, 2.33, 1.91, and 1.00 (p = 0.034). The relative risk for poorer 5-year overall survival by hemoglobin quartile was 2.23 1.30, 0.80, and 1.00 (p <0.001).


CONCLUSIONS
Pretreatment hemoglobin levels predicted for local control and overall survival for larynx cancer in a multivariate model. This relationship has potential therapeutic implications regarding correcting anemia before the initiation of radiotherapy for optimal outcome.
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT 06520, USA.
Edward I
EI
Cho
Clarence T
CT
Sasaki
Bruce G
BG
Haffty
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000032:analysis; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000473:pathology / Q000532:radiotherapy; D005500:Follow-Up Studies; D006441:Hemoglobin A / Q000032:analysis*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000097:blood* / Q000473:pathology / Q000532:radiotherapy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011879:Radiotherapy Dosage
D015415:Biomarkers; D006441:Hemoglobin A