Chemoradiotherapy-induced hemoglobin nadir values and survival in patients with stage III non-small cell lung cancer.
Lung Cancer
; 121: 30-36, 2018 07.
Article
en En
| MEDLINE
| ID: mdl-29858023
ABSTRACT
PURPOSE:
We investigated the influence of change in hemoglobin (Hgb) levels during concurrent chemoradiotherapy (C-CRT) on outcomes of non-anemic patients with stage IIIA/B non-small cell lung cancer (NSCLC).METHODS:
We identified 722 patients with stage IIIA/B NSCLC without anemia at baseline [hemoglobin (Hgb)â¯<12â¯g/dL for women or <13â¯g/dL for men], either nonsmokers or ex-smokers, who received C-CRT between 2007 and 2012. All patients had received 1-3 cycles of platinum-based doublet chemotherapy during radiotherapy to 60-66â¯Gy and had documented Hgb measurements before treatment and at weekly intervals for 6 weeks during the C-CRT. Potential associations were assessed between baseline, nadir, extent of change in Hgb level, and anemia and overall survival (OS), locoregional progression-free survival (LRPFS), and PFS.RESULTS:
The median baseline Hgb level was 13.9â¯g/dL (range 12.0-16.8) and declined to a median 12.4â¯g/dL (range 7.9-16.1) during treatment. Anemia appeared in 237 patients (32.8%) and was more common among women (44.8% vs. 26.5%, Pâ¯<â¯0.001). Neither baseline Hgb level nor change during treatment nor anemia emergence influenced any survival endpoint. Receiver operating curve analysis revealed an Hgb nadir of 11.1â¯g/dL to be associated with outcomes, in that a nadir Hgb <11.1â¯g/dL (in 156 patients) was linked with shorter median OS time (Pâ¯<â¯0.001), LRPFS time (Pâ¯<â¯0.001), and PFS time (Pâ¯<â¯0.001); retained significance for all three endpoints in multivariate analyses; and was more strongly associated with OS in squamous cell carcinoma (Pâ¯<â¯0.001) than in adenocarcinoma (Pâ¯=â¯0.009).CONCLUSION:
Nadir Hgb <11.1â¯g/dL levels during C-CRT were associated with significantly poorer survival times in initially non-anemic patients presenting with locally advanced NSCLC.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_other_respiratory_diseases
/
6_trachea_bronchus_lung_cancer
Asunto principal:
Hemoglobinas
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Carcinoma de Pulmón de Células no Pequeñas
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Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos
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Quimioradioterapia
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Anemia
/
Neoplasias Pulmonares
Tipo de estudio:
Etiology_studies
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Prognostic_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Lung Cancer
Asunto de la revista:
NEOPLASIAS
Año:
2018
Tipo del documento:
Article