title: Effect of pretreatment anemia on treatment outcome of concurrent radiochemotherapy in patients with head and neck cancer.
abstract: 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.
authors.affiliation: Department of Radiation Oncology, L'Hôtel-Dieu de Québec, Québec, Canada. afortin@videotron.ca
authors.forename: André
authors.initials: A
authors.lastname: Fortin
authors.forename: Chang Shu
authors.initials: CS
authors.lastname: Wang
authors.forename: Eric
authors.initials: E
authors.lastname: Vigneault
mesh_terms: 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
chemical_list: D006441:Hemoglobin A; D002945:Cisplatin