PRETREATMENT HEMOGLOBIN LEVEL INFLUENCES LOCAL-CONTROL AND SURVIVAL OF T1-T2 SQUAMOUS-CELL CARCINOMAS OF THE GLOTTIC LARYNX

Purpose: A number of reports have documented the relationship between pretreatment hemoglobin level and local control and/or survival in the treatment of cervix, bladder, and advanced head and neck rumors. Cons ideration of correcting anemia before initiation of radiation therapy may prove increasingly important as clinical trials use intensive indu ction chemotherapy in the treatment of head and neck carcinomas. Neoad juvant chemotherapy may produce anemia, which in turn may reduce the e ffectiveness of subsequent irradiation. Materials and Methods: One hun dred nine patients with T1-2NO squamous cell carcinoma of the glottic larynx were treated with definitive radiotherapy at the Fox Chase Canc er Center between June 1980 and November 1990, Follow-vp times ranged from 26 to 165 months (median, 82). Results: The 2-year local control rate for patients who presented with a hemoglobin level less than or e qual to 13 g/dL was 66%, compared with 95% for patients with a hemoglo bin level more than 13 g/dL (P = .0018). The 2-yeer survival rate for patients with a hemoglobin level less than or equal to 13 g/dL was 46% , compared with 88% for patients with a hemoglobin level more than 13 g/dL (P < .001). Cox proportional hazards regression analysis showed t hat hemoglobin level (P = .0016) wets the only variable that significa ntly influenced local control (P = .0016) and survival (P < .0001). Co nclusion: Patients who presented with hemoglobin levels more than 13 g /dL had significantly higher local control and survival rates. The str ong apparent correlation between hemoglobin level, local control, and survival supports consideration of correcting anemia before initiation of radiation therapy. (C) 1995 by American Society of Clinical Oncolo gy.