Effect of pretreatment anemia on treatment outcome of concurrent radiochemotherapy in patients with head and neck cancer.
OBJECTIVE
To investigate the effect of anemia on outcome of treatment with radiochemotherapy in patients with head-and-neck cancer.


METHODS
The data of 196 patients with Stage II-IV head-and-neck cancer treated with concomitant cisplatin-based radiochemotherapy were retrospectively reviewed. Anemia was defined according to World Health Organization criteria as hemoglobin <130 g/L in men and <120 g/L in women.


RESULTS
Fifty-three patients were classified as anemic, 143 as nonanemic. The 3-year local control rate of anemic and nonanemic patients was 72% and 85%, respectively (p = 0.01). The 3-year overall survival rate of anemic and nonanemic patients was 52% and 77%, respectively (p = 0.004). In multivariate analysis, anemia was the most significant predictor of local control (hazard ratio, 0.37, p = 0.009) and survival (hazard ratio, 0.47, p = 0.007). A dose-effect relationship was also found for local control (p = .04) and survival (0.04) when grouping by hemoglobin concentration: <120, 120-140, and >140 g/L.


CONCLUSIONS
Anemia was strongly associated with local control and survival in this cohort of patients with head-and-neck cancer receiving radiochemotherapy.
Fortin
André
A
Department of Radiation Oncology, L'Hôtel-Dieu de Québec, Québec, Canada. afortin@videotron.ca
Wang
Chang Shu
CS
Vigneault
Eric
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000740:Anemia / Q000097:blood / Q000150:complications* / Q000401:mortality; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000379:methods; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D006441:Hemoglobin A / Q000032:analysis; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D006441:Hemoglobin A; D002945:Cisplatin