MIAMI BEACH--Pretreatment hemoglobin level has been shown to have
an independent effect on local control and survival in patients
with T1-T2 squamous cell carcinomas of the glottic larynx, Douglas
A. Fein, MD, reported at the annual meeting of the American Society
for Therapeutic Radiology and Oncology (ASTRO). Based on this
finding, it may be advisable to correct anemia in these patients
before starting radiation therapy, he said.
The study involved 109 patients with invasive, previously untreated
T1-T2 squamous cell carcinoma of the glottic larynx (the true
vocal cord) who were treated with definitive radiotherapy at the
Fox Chase Cancer Center during a recent 10-year period.
Dr. Fein, an attending radiation oncologist at Fox Chase, reported
that patients who presented with hemoglobin levels greater than
13 g/dL had significantly higher local control and survival rates.
The 2-year local control rate in patients whose pretreatment hemoglobin
level was less than or equal to 13 g/dL was 66%, compared with
95% for patients with a level of more than 13 g/dL. The 2-year
survival rates were 46% and 88% for the two groups, respectively.
Sex, tumor stage, total dose, tobacco pack-years, tumor differentiation,
age, and overall treatment time did not influence local control
or survival, he said.
Dr. Fein noted that while it may be too early to recommend altering
therapy based on these findings, potential methods of improving
local control rates and survival should be explored. Recombinant
erythropoietin (epoetin alfa, Epogen, Procrit) has been shown
to be safe and effective in treating malignancy-related anemia.
Whether administration of erythropoietin during primary radiotherapy
can improve local control rates and survival can only be answered
in a phase III trial that prospectively randomizes patients to
observation or treatment, he added.