1 Baskent University Medical Faculty, Department of Radiation Oncology, Adana, Turkey.
2 Nicosia Dr. Burhan Nalbantoglu Goverment Hospital, Radiation Oncology Clinics, Nicosia, Turkish Republic of Northern Cyprus.
Int J Biol Markers. 2019 Jun;34(2):139-147. doi: 10.1177/1724600818821688. Epub 2019 Mar 13.
To retrospectively investigate the influence of pretreatment anemia and hemoglobin levels on the survival of nasopharyngeal carcinoma patients treated with concurrent chemoradiotherapy (C-CRT).
A total of 149 nasopharyngeal carcinoma patients who received C-CRT were included. All patients had received 70 Gy to the primary tumor plus the involved lymph nodes, and 59.4 Gy and 54 Gy to the intermediate- and low-risk neck regions concurrent with 1-3 cycles of cisplatin. Patients were dichotomized into non-anemic and anemic (hemoglobin <12 g/dL (women) or <13 g/dL (men)) groups according to their pre-treatment hemoglobin measures. Receiver operating characteristic (ROC) curve analysis was utilized for accessibility of a pre-treatment hemoglobin cut-off that impacts outcomes. Potential interactions between baseline anemia status and hemoglobin measures and overall survival, locoregional progression-free survival (LRPFS), and progression-free survival were assessed.
Anemia was evident in 36 patients (24.1%), which was related to significantly shorter overall survival (=0.007), LRPFS (<0.021), and progression-free survival (=0.003) times; all three endpoints retained significance in multivariate analyses (<0.05, for each). A baseline hemoglobin value of 11.0 g/dL exhibited significant association with outcomes in ROC curve analysis: hemoglobin <11.0 g/dL (N=26) was linked with shorter median overall survival (<0.001), LRPFS (=0.004), and progression-free survival (<0.001) times, which also retained significance for all three endpoints in multivariate analyses and suggested a stronger prognostic worth for the hemoglobin <11.0 g/dL cut-off value than the anemia status.
Pre-C-CRT hemoglobin <11.0 g/dL has a stronger prognostic worth than the anemia status with regard to LRPFS, progression-free survival, and overall survival for nasopharyngeal carcinoma patients.
回顾性分析同期放化疗（C-CRT）治疗的鼻咽癌患者预处理贫血和血红蛋白水平对生存的影响。
共纳入 149 例接受 C-CRT 的鼻咽癌患者。所有患者均接受 70 Gy 原发肿瘤加受累淋巴结照射，59.4 Gy 和 54 Gy 中低危颈区同期接受 1-3 周期顺铂化疗。根据治疗前血红蛋白测量值，患者分为非贫血组和贫血组（血红蛋白<12 g/dL（女性）或<13 g/dL（男性））。采用受试者工作特征（ROC）曲线分析确定影响预后的治疗前血红蛋白截断值。评估基线贫血状态与血红蛋白水平与总生存、局部区域无进展生存（LRPFS）和无进展生存之间的潜在相互作用。
36 例（24.1%）患者出现贫血，总生存（=0.007）、LRPFS（<0.021）和无进展生存（=0.003）时间明显缩短；多变量分析中所有三个终点均有意义（<0.05，各终点）。ROC 曲线分析显示，血红蛋白基线值为 11.0 g/dL 与结局显著相关：血红蛋白<11.0 g/dL（N=26）与中位总生存时间缩短（<0.001）、LRPFS（=0.004）和无进展生存（<0.001）相关，多变量分析中所有三个终点仍有意义，提示血红蛋白<11.0 g/dL 截断值比贫血状态具有更强的预后价值。
与贫血状态相比，C-CRT 前血红蛋白<11.0 g/dL 对鼻咽癌患者的 LRPFS、无进展生存和总生存具有更强的预后价值。
