Influence of hemoglobin levels on survival after radical treatment of XXXX with radiotherapy.

@entity1 @entity5 @entity900 @entity418 @entity204 @entity1487
INTRODUCTION: The objective was to investigate the possible prognostic value of blood hemoglobin concentration in the outcome of radical treatment for locally advanced @entity418 . MATERIALS AND METHOD: This was a retrospective analysis of data for 85 @entity1 treated for locally advanced @entity418 between January 1991 and January 1997 with chemoradiotherapy alone or as neoadjuvant therapy. All @entity1 received chemotherapy (4 cycles of @entity900 100 mg/m2 on day 1, and continuous infusion @entity1487 1 g/m2 per day on days 1-5) with concomitant radiotherapy (40 Gy at 2 Gy/session to the @entity5 and mediastinum). The response was evaluated after 4 weeks. 69 @entity1 continued to receive chemoradiotherapy only to a total dose of 60-64 Gy to the @entity5 with a 2-cm margin. Sixteen @entity1 underwent radical surgery. Hemoglobin levels were measured before combined treatment in all @entity1 . The prognostic value of hemoglobin concentration was analyzed statistically, along with other @entity1 -, @entity5 - and treatment-related factors. RESULTS: Mean follow-up time: 82 months (range 60- 99 months). Chemoradiotherapy was followed by an overall clinical response of 69.4%, with complete clinical response in 24.7% of the @entity1 . Mean survival time was 12 months, and overall likelihood of survival after 3 years was 13%. Mean time to progression: 5 months. Median survival time was 12 months in the 69 @entity1 who underwent chemoradiotherapy alone, and 26 months in @entity1 who underwent radical surgery. Univariate analysis showed a hemoglobin value of > 13 g/dl to be a prognostic factor for better survival, along with performance status according to the ECOG classification, weight loss < 10%, @entity5 stage, @entity5 length, and complete response to chemoradiotherapy. Multivariate analysis showed that only hemoglobin concentration was an independent prognostic factor: for each unit increase in hemoglobin level, the risk of @entity204 from @entity418 decreased by 5%. In the subgroup of @entity1 who did not undergo surgery, hemoglobin concentration was also an independent prognostic factor along with complete clinical response. CONCLUSIONS: As found for other @entity5 , hemoglobin level was a determining factor in the prognosis for treatment outcome in @entity1 with @entity418 . Our findings require confirmation in randomized studies and further documentation of the probable benefits of correcting hemoglobin levels.
