Pretreatment Levels of Hemoglobin May Predict Outcomes of Larynx Cancer Patients

MIAMI BEACH--Pretreatment hemoglobin level has been shown to havean independent effect on local control and survival in patientswith T1-T2 squamous cell carcinomas of the glottic larynx, DouglasA. Fein, MD, reported at the annual meeting of the American Societyfor Therapeutic Radiology and Oncology (ASTRO). Based on thisfinding, it may be advisable to correct anemia in these patientsbefore starting radiation therapy, he said.

The study involved 109 patients with invasive, previously untreatedT1-T2 squamous cell carcinoma of the glottic larynx (the truevocal cord) who were treated with definitive radiotherapy at theFox Chase Cancer Center during a recent 10-year period.

Dr. Fein, an attending radiation oncologist at Fox Chase, reportedthat patients who presented with hemoglobin levels greater than13 g/dL had significantly higher local control and survival rates.

The 2-year local control rate in patients whose pretreatment hemoglobinlevel was less than or equal to 13 g/dL was 66%, compared with95% for patients with a level of more than 13 g/dL. The 2-yearsurvival rates were 46% and 88% for the two groups, respectively.

Sex, tumor stage, total dose, tobacco pack-years, tumor differentiation,age, and overall treatment time did not influence local controlor survival, he said.

Dr. Fein noted that while it may be too early to recommend alteringtherapy based on these findings, potential methods of improvinglocal control rates and survival should be explored. Recombinanterythropoietin (epoetin alfa, Epogen, Procrit) has been shownto be safe and effective in treating malignancy-related anemia.

Whether administration of erythropoietin during primary radiotherapycan improve local control rates and survival can only be answeredin a phase III trial that prospectively randomizes patients toobservation or treatment, he added.