title: Hemoglobin levels do not predict biochemical outcome for localized prostate cancer treated with neoadjuvant androgen-suppression therapy and external-beam radiotherapy.
abstract: OBJECTIVE
  To investigate whether hemoglobin (Hb) levels affect outcome in men with localized prostate adenocarcinoma (LPA) treated with neoadjuvant androgen-suppression therapy (NAST) and external-beam radiotherapy (EBRT).
  
  
  METHODS
  A total of 563 men with LPA treated with NAST (median: 5.3 months) and EBRT who had Hb levels during treatment were retrospectively reviewed. Patient, tumor, and treatment variables, including the following Hb variables, were subjected to univariate and multivariable analyses to identify factors that predict biochemical control (bNED) and overall survival (OS): pre-EBRT Hb, Hb nadir during EBRT, and change in Hb from pre-EBRT to nadir during EBRT.
  
  
  RESULTS
  Median PSA follow-up was 4.25 years. Forty-nine percent of men were anemic during EBRT, with a median Hb of 13.4 g/dL, and 68% experienced a decline in Hb from pre-EBRT to during EBRT of median 0.6 g/dL. Five-year Nadir+2 bNED and OS rates were similar for anemic and nonanemic patients during EBRT. High percent-positive biopsies, PSA and Gleason score, and use of AA monotherapy predicted worse bNED. High stage and age predicted worse OS. Hb variables were not predictive of bNED or OS.
  
  
  CONCLUSIONS
  Anemia is a common side effect of NAST and is usually mild. Hb levels, however, do not predict biochemical control or survival.
authors: Radiation Oncology Program, British Columbia Cancer Agency-Vancouver Island Centre, Victoria, British Columbia, Canada. hpai@bccancer.bc.ca
authors: Howard Huaihan
authors: HH
authors: Pai
authors: Charles
authors: C
authors: Ludgate
authors: Tom
authors: T
authors: Pickles
authors: Chuck
authors: C
authors: Paltiel
authors: Alex
authors: A
authors: Agranovich
authors: Eric
authors: E
authors: Berthelet
authors: Graeme
authors: G
authors: Duncan
authors: Charmaine
authors: C
authors: Kim-Sing
authors: Winkle
authors: W
authors: Kwan
authors: Jan
authors: J
authors: Lim
authors: Mitchell
authors: M
authors: Liu
authors: Scott
authors: S
authors: Tyldesley