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Pretreatment Levels of Hemoglobin May Predict Outcomes of Larynx Cancer Patients

Pretreatment Levels of Hemoglobin May Predict Outcomes of Larynx Cancer Patients

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.

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