title: Clinical relevance of hemoglobin level in cervical cancer patients administered definitive radiotherapy.
abstract: The prognostic impact of pretreatment hemoglobin (Hb) level and its changes during definitive radiotherapy was evaluated by univariate and multivariate analysis in the group of 453 FIGO IB-IIIB cervical cancer patients. Pretreatment anemia (Hb < 12 g/dl) was present in 148 patients (33%), and anemia at the end of irradiation in 48%; in 64% Hb level declined during therapy. Median overall survival in patients with initial Hb >or=12 g/dl was 66 months compared to 22 months in those with lower baseline Hb levels (p = 0.0001). This difference was mainly due to increased risk of distant spread in anemic patients (40% compared to 25% in subjects with pretreatment Hb >or=12 g/dl; p = 0.001). Baseline Hb >or=12 g/dl was also associated with longer disease-free survival and improved local control. Declining Hb level during radiotherapy predicted for impaired 5-year disease-free survival and local control probability. In multivariate analysis, low pretreatment Hb level remained associated with worse overall and disease-free survival, whereas adverse impact of declining Hb level on outcome was not observed. With regard to other clinical factors, stage and tumor extension (uni- or bilateral parametrium involvement for Stage III) were the only independent determinants of prognosis.
authors.affiliation: Department of Oncology and Radiotherapy, Medical University of Gdansk, Poland. oncol@amg.gda.pl
authors.forename: Krystyna
authors.initials: K
authors.lastname: Serkies
authors.forename: Andrzej
authors.initials: A
authors.lastname: Badzio
authors.forename: Jacek
authors.initials: J
authors.lastname: Jassem
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000740:Anemia / Q000150:complications*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D011044:Poland; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000097:blood* / Q000150:complications* / Q000532:radiotherapy*
chemical_list: D006454:Hemoglobins