alexa Involvement of difference in decrease of hemoglobin level in poor prognosis of Stage I and II nasopharyngeal carcinoma: implication in outcome of radiotherapy.


Journal of Integrative Oncology

Author(s): Gao J, Tao YL, Li G, Yi W, Xia YF

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Abstract PURPOSE: To investigate the effect of hemoglobin (Hb) concentration and the difference in its decrease during treatment on outcome of radiotherapy (RT) alone for patients with Stage I and II nasopharyngeal carcinoma. METHODS AND MATERIALS: A total of 572 patients with Stage I-II nasopharyngeal carcinoma with RT alone between January 2001 and December 2004 were retrospectively analyzed. Patient characteristics, tumor variables, and Hb level, including pre-RT Hb, mid-RT Hb, and dynamic change of Hb between pre- and post- RT and its difference in decrease (▵Hb) were subjected to univariate and multivariable analysis to identify factors that predict disease-specific survival (DSS), local regional recurrence-free survival (LRFS), and metastases-free survival (MFS). RESULTS: The 5-year DSS was poorer in the Hb continuous decrease group than in the Hb noncontinuous decrease group (84\% vs. 89\%; p = 0.008). There was poorer 5-year DSS in patients with ▵Hb of >11.5 g/L than in those with ▵Hb of ≤11.5 g/L (82\% vs. 89\%; p = 0.001), and poorer LRFS (79\% vs. 83\%; p = 0.035). Univariate and multivariate analysis showed that Hb decrease difference with greater than 11.5 g/L was an independent prognostic factor for DSS and LRFS. CONCLUSIONS: The difference in decrease of Hb level during the course of radiation treatment appeared as a poor prognostic factor in Stage I and II nasopharyngeal carcinoma patients. Copyright © 2012 Elsevier Inc. All rights reserved. This article was published in Int J Radiat Oncol Biol Phys and referenced in Journal of Integrative Oncology

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