Baghi M, Wagenblast J, Hambek M, Moertel S, Gstoettner W, Strebhardt K, Knecht R
Department of Otorhinolaryngology, School of Medicine, J. W. Goethe University, Frankfurt am Main, Germany.
Clin Otolaryngol. 2008 Jun;33(3):245-51. doi: 10.1111/j.1749-4486.2008.01702.x.
To investigate the prognostic value of the pre-treatment haemoglobin level in patients with advanced squamous cell head and neck cancer treated with induction polychemotherapy.
Seventy-two patients with advanced squamous cell head and neck cancer received primary combination chemotherapy consisting of docetaxel 75 mg/m(2) on day 1, cisplatin 100 mg/m(2) on day 1, and 5-fluorouracil (5-FU) 1000 mg/m(2)/day on days 1-4 (total dose 4000 mg/m(2)), repeated on days 1, 22 and 43 followed by chemoradiation. The data collected included pre-treatment haemoglobin, response to treatment, disease-free and overall survival.
The pre-treatment haemoglobin level was found to be a significant predictor of response to induction chemotherapy (P = 0.01) and an independent predictor of overall survival [hazard ratio (HR) 0.77, 95% confidence interval (CI) 0.58-1.03, P = 0.0001] and disease free survival (HR 2.09, 95% CI 1.41-3.09, P = 0.0001). Furthermore N-stage was found to be a significant prognostic factor of overall survival (HR 9.24, 95% CI 6.90-21.34, P = 0.005). The Eastern Cooperative Oncology Group performance status scale was also found to be significant for disease free survival (HR 7.66, 95% CI 2.61-22.46, P = 0.003).
In patients with advanced squamous cell head and neck cancer, the haemoglobin level prior to induction chemotherapy is significantly related to outcome including response and survival.
探讨诱导多药化疗的晚期头颈部鳞状细胞癌患者治疗前血红蛋白水平的预后价值。
72例晚期头颈部鳞状细胞癌患者接受了初始联合化疗，具体方案为第1天给予多西他赛75mg/m²、顺铂100mg/m²，第1 - 4天给予5-氟尿嘧啶（5-FU）1000mg/m²/天（总剂量4000mg/m²），于第1、22和43天重复给药，随后进行放化疗。收集的数据包括治疗前血红蛋白、治疗反应、无病生存期和总生存期。
发现治疗前血红蛋白水平是诱导化疗反应的显著预测指标（P = 0.01），也是总生存期[风险比（HR）0.77，95%置信区间（CI）0.58 - 1.03，P = 0.0001]和无病生存期（HR 2.09，95% CI 1.41 - 3.09，P = 0.0001）的独立预测指标。此外，发现N分期是总生存期的显著预后因素（HR 9.24，95% CI 6.90 - 21.34，P = 0.005）。东部肿瘤协作组体能状态量表对无病生存期也具有显著意义（HR 7.66，95% CI 2.61 - 22.46，P = 0.003）。
在晚期头颈部鳞状细胞癌患者中，诱导化疗前的血红蛋白水平与包括反应和生存在内的预后显著相关。
