TY - JOUR
T1 - Association of hemoglobin level with survival in cervical carcinoma patients treated with concurrent cisplatin and radiotherapy
T2 - A Gynecologic Oncology Group Study
AU - Winter, William E.
AU - Maxwel, G. Larry
AU - Tian, Chunqiao
AU - Sobel, Eugene
AU - Scott Rose, G.
AU - Thomas, Gillian
AU - Carlson, Jay W.
N1 - Funding Information:
This study was supported by National Cancer Institute grants to the Gynecologic Oncology Group Administrative Office (CA 27469) and the Gynecologic Oncology Group Statistical Office (CA 37517). The following member institutions participated in this study: University of Alabama at Birmingham, Oregon Health Sciences University, Duke University Medical Center, Abington Memorial Hospital, University of Rochester Medical Center, Walter Reed Army Medical Center, Wayne State University, University of Minnesota Medical School, Emory University Clinic, University of Southern California at Los Angeles, University of Mississippi Medical Center, Colorado Gynecologic Oncology Group, P.C., University of California at Los Angeles, University of Washington, University of Pennsylvania Cancer Center, University of Miami School of Medicine, Milton S. Hershey Medical Center, Georgetown University Hospital, University of Cincinnati, University of North Carolina School of Medicine, University of Iowa Hospitals and Clinics, University of Texas Southwestern Medical Center at Dallas, Indiana University Medical Center, Wake Forest University School of Medicine, Albany Medical College, University of California Medical Center at Irvine, Tufts-New England Medical Center, Rush-Presbyterian-St. Luke's Medical Center, SUNY Downstate Medical Center, University of Kentucky, Eastern Virginia Medical School, Community Clinical Oncology Program, The Cleveland Clinic Foundation, Johns Hopkins Oncology Center, SUNY at Stony Brook, Eastern Pennsylvania GYN/ONC Center, P.C., Washington University School of Medicine, Cooper Hospital/University Medical Center, Columbus Cancer Council, University of Massachusetts Medical Center, Fox Chase Cancer Center, Medical University of South Carolina, Women's Cancer Center, University of Oklahoma, University of Virginia, University of Chicago, University of Arizona Health Science Center, Tacoma General Hospital, Mayo Clinic, Case Western Reserve University, Tampa Bay Cancer Consortium, North Shore University Hospital, Brookview Research, Inc., The New York Hospital/Cornell Medical Center, and Ellis Fischel Cancer Center.
PY - 2004/8
Y1 - 2004/8
N2 - Objectives. To determine if there is an association of hemoglobin level before or during concurrent cisplatin and radiotherapy (RT) with disease outcome in women with locally advanced cervical cancer, and to assess if the association is particularly significant at a specific interval or time during treatment. Methods. A retrospective review of 494 patients treated on two consecutive prospective Gynecologic Oncology Group (GOG) trials was conducted. Demographic data, pathologic information, treatment-related factors, and hemoglobin values at baseline and during each week of therapy were collected. Cox proportional hazards model was performed to evaluate the impact of hemoglobin level on progression-free survival (PFS). Results. Of the combined patients, 278 (56%) and 216 (44%) were diagnosed with Stage II and Stage III/IV disease, respectively. Controlling for age, race, performance status, disease stage, tumor size, cell type, and duration of radiotherapy, mean hemoglobin values during treatment were predictive of disease progression (P < 0.0001). The pretreatment level was not significant when hemoglobin levels during treatment were included in the multivariate analysis. When the 6-week treatment course was divided into 2-week periods (early, middle, and late), analysis revealed hemoglobin values during the late period were the most predictive of disease progression (P = 0.0289). Conclusions. Hemoglobin levels during combined radiotherapy and cisplatin were independent predictors of treatment outcome in advanced cervical carcinoma. The pretreatment level was not a significant predictor of outcome when hemoglobin levels during treatment were included in the multivariate regression model. Levels in the last part of treatment were the most predictive of disease recurrence and survival.
AB - Objectives. To determine if there is an association of hemoglobin level before or during concurrent cisplatin and radiotherapy (RT) with disease outcome in women with locally advanced cervical cancer, and to assess if the association is particularly significant at a specific interval or time during treatment. Methods. A retrospective review of 494 patients treated on two consecutive prospective Gynecologic Oncology Group (GOG) trials was conducted. Demographic data, pathologic information, treatment-related factors, and hemoglobin values at baseline and during each week of therapy were collected. Cox proportional hazards model was performed to evaluate the impact of hemoglobin level on progression-free survival (PFS). Results. Of the combined patients, 278 (56%) and 216 (44%) were diagnosed with Stage II and Stage III/IV disease, respectively. Controlling for age, race, performance status, disease stage, tumor size, cell type, and duration of radiotherapy, mean hemoglobin values during treatment were predictive of disease progression (P < 0.0001). The pretreatment level was not significant when hemoglobin levels during treatment were included in the multivariate analysis. When the 6-week treatment course was divided into 2-week periods (early, middle, and late), analysis revealed hemoglobin values during the late period were the most predictive of disease progression (P = 0.0289). Conclusions. Hemoglobin levels during combined radiotherapy and cisplatin were independent predictors of treatment outcome in advanced cervical carcinoma. The pretreatment level was not a significant predictor of outcome when hemoglobin levels during treatment were included in the multivariate regression model. Levels in the last part of treatment were the most predictive of disease recurrence and survival.
KW - Cervical cancer
KW - Chemoradiation
KW - Hemoglobin
UR - http://www.scopus.com/inward/record.url?scp=3543083957&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2004.04.008
DO - 10.1016/j.ygyno.2004.04.008
M3 - Article
AN - SCOPUS:3543083957
SN - 0090-8258
VL - 94
SP - 495
EP - 501
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 2
ER -