title: Hemoglobin monitoring in head and neck cancer patients undergoing radiotherapy.
abstract: OBJECTIVE
  Anemia is a well-recognized factor for local recurrence and decreased survival in cancer patients undergoing radiotherapy. Additionally, lower hemoglobin (Hb) levels have a negative impact on radiotherapy efficacy and response rates. The objective of this audit was to investigate how frequently Hb levels were observed in head and neck cancer patients receiving radiotherapy within a multidisciplinary team setting.
  
  
  METHODS
  We performed a retrospective first-cycle audit in a university hospital in Glasgow that is a tertiary referral center for head and neck cancer. Included were 78 patients with head and neck cancer who were undergoing radiotherapy. Online laboratory services and clinical case sheets were checked for each patient to monitor the frequency of observation of Hb levels before, during, and after radiotherapy.
  
  
  RESULTS
  Of these 78 patients, only 49 had their Hb level checked before radiotherapy treatment, only 9 during radiotherapy, and only 27 after completion of radiotherapy treatment (p < 0.0001). Of the 49 patients with preradiotherapy Hb levels available, 24% were found to be anemic; none of these patients had their Hb monitored during radiotherapy, and only 4 had Hb levels recorded after completion of treatment.
  
  
  CONCLUSIONS
  This audit has highlighted that despite evidence emphasizing that anemia in cancer is an independent prognostic factor for recurrence, there is no formal protocol for Hb monitoring in head and neck cancer patients undergoing radiotherapy. The audit has also demonstrated that Hb monitoring is infrequently performed and that subsequent observation of the Hb level is suboptimal.
authors.affiliation: Department of Otolaryngology, Southern General Hospital, Greater Glasgow and Clyde National Health Service Trust, Glasgow, Scotland.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Montgomery
authors.forename: Mohammed Iqbal
authors.initials: MI
authors.lastname: Syed
authors.forename: Indu
authors.initials: I
authors.lastname: Rana
authors.forename: Jatinder
authors.initials: J
authors.lastname: Singh
authors.forename: Louise J
authors.initials: LJ
authors.lastname: Clark
mesh_terms: D000368:Aged; D000740:Anemia / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000150:complications / Q000503:physiopathology / Q000532:radiotherapy; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic
chemical_list: D006454:Hemoglobins