PRETREATMENT HEMOGLOBIN LEVEL INFLUENCES LOCAL-CONTROL AND SURVIVAL OF T1-T2 SQUAMOUS-CELL CARCINOMAS OF THE GLOTTIC LARYNX

Purpose: A number of reports have documented the relationship between pretreatment hemoglobin level and local control and/or survival in the treatment of cervix, bladder, and advanced head and neck rumors. Consideration of correcting anemia before initiation of radiation therapy may prove increasingly important as clinical trials use intensive induction chemotherapy in the treatment of head and neck carcinomas. Neoadjuvant chemotherapy may produce anemia, which in turn may reduce the effectiveness of subsequent irradiation. Materials and Methods: One hundred nine patients with T1-2NO squamous cell carcinoma of the glottic larynx were treated with definitive radiotherapy at the Fox Chase Cancer Center between June 1980 and November 1990, Follow-vp times ranged from 26 to 165 months (median, 82). Results: The 2-year local control rate for patients who presented with a hemoglobin level less than or equal to 13 g/dL was 66%, compared with 95% for patients with a hemoglobin level more than 13 g/dL (P = .0018). The 2-yeer survival rate for patients with a hemoglobin level less than or equal to 13 g/dL was 46%, compared with 88% for patients with a hemoglobin level more than 13 g/dL (P < .001). Cox proportional hazards regression analysis showed that hemoglobin level (P = .0016) wets the only variable that significantly influenced local control (P = .0016) and survival (P < .0001). Conclusion: Patients who presented with hemoglobin levels more than 13 g/dL had significantly higher local control and survival rates. The strong apparent correlation between hemoglobin level, local control, and survival supports consideration of correcting anemia before initiation of radiation therapy. (C) 1995 by American Society of Clinical Oncology.