Background & objective: Oxygen increases tumor sensitivity to radiotherapy; tumor hypoxia is more prevalent in tumor patients with pretreatment hemoglobin concentration of < 130 g/L. This study was to evaluate impact of pre-radiotherapy hemoglobin level on radiotherapy outcome of nasopharyngeal carcinoma (NPC) patients.
Methods: Clinical and follow-up data of 166 NPC patients received definitive radiotherapy from 1999 to 2000 were reviewed. Pre-radiotherapy hemoglobin levels were stratified as high (> or =130 g/L) and low (< 130 g/L). Cox regression analysis was used to determine factors affecting local control.
Results: The median pre-radiotherapy hemoglobin level of the 166 patients was 135 (85-189) g/L. Hemoglobin was < 130 g/L in 68 (41%) patients, and > or =130 g/L in 98 (59%) patients. The pre-radiotherapy hemoglobin level of < 130 g/L was related to low 3-year local relapse-free survival rate (78% vs. 90%, P=0.015), but had no relations with distant metastasis-free survival (75% vs.77%, P=0.763) and overall survival rates (73% vs. 83%, P=0.056). Multivariate analysis showed that pre-radiotherapy hemoglobin level, T stage, and gender were independent prognostic factors for local failure.
Conclusions: Pre-radiotherapy hemoglobin of < 130 g/L is a prognostic factor for local control of NPC. Strategies for maintaining pre-radiotherapy hemoglobin of > or =130 g/L before radiotherapy and during treatment should be further explored.