ANEMIA IS ASSOCIATED WITH LOWER LOCAL-REGIONAL CONTROL AND SURVIVAL AFTER RADIATION-THERAPY FOR HEAD AND NECK-CANCER - A PROSPECTIVE-STUDY

PURPOSE: To evaluate the prognostic value of anemia in squamous cell c arcinomas in the head and neck treated with curative radiation therapy alone. MATERIALS AND METHODS: In a prospective study, the hemoglobin level was measured prior to radiation therapy in 217 patients (188 [87 %] men and 29 [13%] women) with cancer of the oral cavity (n = 61 [28% ]), oropharynx (n = 53 [24%]), hypopharynx (n = 21[10%]), and larynx ( n = 82 [38%]). Anemia, defined as a hemoglobin level below 13.5 g/dL i n men and below 12.0 g/dL in women, was diagnosed in 58 (31%) of the m en and five (17%) of the women. Median follow-up was 29 months (range, 2-63 months). RESULTS: The 2-year actuarial probability of local-regi onal control was 69% (95% confidence interval, 63%, 76%). Multivariate analysis showed the relative risk of failure of local-regional contro l to increase for stage T3 and T4 tumors (1.8 [95% confidence interval , 1.1, 3.1]), stage N3 nodes (3.6 [95% confidence interval, 1.8, 7.1]) , weight loss (2.2 [95% confidence interval, 1.3, 4.0]), and anemia (1 .6 [95% confidence interval, 1.0-2.7]). The relative risk of death inc reased for stage T3 and T4 tumors (2.5 [95% confidence interval, 1.4, 4.3]), N3 nodes (4.0 [95% confidence interval, 2.0, 7.9]), oral cavity tumors (2.0 [95% confidence interval, 1.2, 3.2]), male sex (4.1 [95% confidence interval, 1.3, 13.1]), weight loss (2.2 [95% confidence int erval, 1.3, 3.7]), and anemia (1.7 [95% confidence interval, 1.03, 2.7 ]). CONCLUSION: Moderate anemia appeared to be an independent prognost ic factor in squamous cell carcinoma of the head and neck treated with radiation therapy alone.