Objectives. To determine if there is an association of hemoglobin level before or during concurrent cisplatin and radiotherapy (RT) with disease outcome in wo men with locally advanced cervical cancer, and to assess i...Objectives. To determine if there is an association of hemoglobin level before or during concurrent cisplatin and radiotherapy (RT) with disease outcome in wo men with locally advanced cervical cancer, and to assess if the association is p articularly 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, patholo gic information, treatment-related factors, and hemoglobin values at baseline a nd during each week of therapy were collected. Cox proportional hazards model wa s performed to evaluate the impact of hemoglobin level on progression-free surv ival (PFS). Results. Of the combined patients, 278 (56%) and 216 (44%) were di agnosed with Stage II and Stage III/IV disease, respectively. Controlling for ag e, race, performance status, disease stage, tumor size, cell type, and duration of radiotherapy, mean hemoglobin values during treatment were predictive of dise ase progression (P < 0.0001). The pretreatment level was not significant when he moglobin levels during treatment were included in the multivariate analysis. Whe n the 6-week treatment coursewas divided into 2-week periods (early,middle, an d late), analysis revealed hemoglobin values during the late period were the mos t predictive of disease progression (P = 0.0289). Conclusions. Hemoglobin levels during combined radiotherapy and cisplatin were independent predictors of treat ment outcome in advanced cervical carcinoma. The pretreatment level was not a si gnificant predictor of outcome when hemoglobin levels during treatment were incl uded in the multivariate regression model. Levels in the last part of treatment were the most predictive of disease recurrence and survival.展开更多
文摘Objectives. To determine if there is an association of hemoglobin level before or during concurrent cisplatin and radiotherapy (RT) with disease outcome in wo men with locally advanced cervical cancer, and to assess if the association is p articularly 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, patholo gic information, treatment-related factors, and hemoglobin values at baseline a nd during each week of therapy were collected. Cox proportional hazards model wa s performed to evaluate the impact of hemoglobin level on progression-free surv ival (PFS). Results. Of the combined patients, 278 (56%) and 216 (44%) were di agnosed with Stage II and Stage III/IV disease, respectively. Controlling for ag e, race, performance status, disease stage, tumor size, cell type, and duration of radiotherapy, mean hemoglobin values during treatment were predictive of dise ase progression (P < 0.0001). The pretreatment level was not significant when he moglobin levels during treatment were included in the multivariate analysis. Whe n the 6-week treatment coursewas divided into 2-week periods (early,middle, an d late), analysis revealed hemoglobin values during the late period were the mos t predictive of disease progression (P = 0.0289). Conclusions. Hemoglobin levels during combined radiotherapy and cisplatin were independent predictors of treat ment outcome in advanced cervical carcinoma. The pretreatment level was not a si gnificant predictor of outcome when hemoglobin levels during treatment were incl uded in the multivariate regression model. Levels in the last part of treatment were the most predictive of disease recurrence and survival.
