Declining hemoglobin during chemoradiotherapy for locally advanced non-small cell lung cancer is significant

Rob MacRae, Yu Shyr, David Johnson, Hak Choy

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Background and purpose: Tumor hypoxia and anemia have been linked to poor overall survival and local control in carcinomas of both the uterine cervix and the head and neck for patients undergoing radiotherapy. Little is known about the effect of these factors on the outcome of NSCLC patients with locally advanced disease undergoing chemoradiation therapy. Materials and methods: To examine the impact of anemia in stage III NSCLC patients undergoing combined modality therapy, we reviewed our database from three sequential trials of concurrent weekly paclitaxel +/- carboplatin and radiation therapy. 115 pts from 17 institutions were enrolled from 4/94 to 5/97. In this series, hemoglobin values were collected before treatment and weekly during radiotherapy. We correlated baseline Hb and Hb changes during chemoradiation treatment with overall survival. Results: Although pretreatment anemia was common (30% Hb=110-130 g/l, 16% Hb <110 g/l), log-rank analyses of presenting Hb, average Hb and minimum Hb during treatment were not statistically significantly predictive of survival. However in a Cox model, declining hemoglobin during chemoradiation had a statistically significant impact on survival. Conclusions: These analyses reveal that a decline in hemoglobin during chemoradiation for stage III NSCLC has a statistically significant correlation with overall survival. Strategies maximizing hemoglobin during combined modality therapy need further exploration in well-planned randomized trials.

Original languageEnglish (US)
Pages (from-to)37-40
Number of pages4
JournalRadiotherapy and Oncology
Volume64
Issue number1
DOIs
StatePublished - Jul 2002

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Chemoradiotherapy
Non-Small Cell Lung Carcinoma
Hemoglobins
Survival
Anemia
Combined Modality Therapy
Radiotherapy
Carboplatin
Therapeutics
Paclitaxel
Proportional Hazards Models
Cervix Uteri
Neck
Head
Databases
Carcinoma

Keywords

  • Combined modality therapy
  • Hemoglobin
  • Non-small cell lung cancer

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Urology

Cite this

Declining hemoglobin during chemoradiotherapy for locally advanced non-small cell lung cancer is significant. / MacRae, Rob; Shyr, Yu; Johnson, David; Choy, Hak.

In: Radiotherapy and Oncology, Vol. 64, No. 1, 07.2002, p. 37-40.

Research output: Contribution to journalArticle

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