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.
Cho
Edward I
EI
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT 06520, USA.
Sasaki
Clarence T
CT
Haffty
Bruce G
BG
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