Anemia before and during concurrent chemoradiotherapy in patients with cervical carcinoma: Effect on progression-free survival

Abstract

To determine the impact of anemia before and during chemoradiation in patients with cervical cancer, we collected data on hemoglobin (Hb) levels before and during treatment from 60 unselected patients with cervical carcinoma. All patients had FIGO stage IB to IVA disease and were treated with concurrent chemoradiation for the aim of cure. Patients with an Hb value below or equal to the lower 25th quartile were considered anemic. Progression-free survival (PFS) was evaluated by univariate and multivariate analyses. After a median follow-up of 26.3 months, 20 patients developed disease progression. The lowest Hb during chemoradiation (nadir Hb), the stage of disease, and parametrial involvement were correlated significantly with PFS. On multivariate analysis, the nadir Hb (relative risk [RR] 0.29) and tumor stage (RR 3.4) remained the only prognostically relevant factors predicting PFS. At 60 months the PFS was 39.1% for anemic patients and 48.0% for nonanemic patients (P < 0.0002). In patients undergoing chemoradiation for cervical carcinoma, a low nadir Hb is highly predictive of shortened PFS, whereas the Hb before treatment is prognostically not significant.

Impact of hemoglobin on survival of cervical carcinoma patients treated with concurrent chemoradiotherapy is dependent on lymph node metastasis findings by magnetic resonance imaging

“…After this clinical announcement, there have been several reports that anemia is an important prognostic factor in patients treated with chemoradiation (6,7,9) .…”

Srinagarind Hospital experience in concurrent chemoradiation for 100 patients with stage IB2 to IVA uterine cervical cancer

“…This was similar to the report of Veerasarn et al, 26 who found that the only prognostic factor to improve the complete response rate was the Hb level. However, Obermair et al 27 28 suggested that the optimal level of Hb in pretreatment cervical cancer patients should be at 12-14 g/dl. The present study, fortunately, found no grade 3 or 4 nonhematologic toxicities, which would have interrupted the treatment schedule.…”

Prognostic factors for cervical cancer patients stages IB-IVA treated by radiotherapy with or without chemotherapy

“…Normally, patients with cervical cancer in advanced stage (stage IIB-IVA as identified by the International Federation of Gynecology and Obstetrics (FIGO)) receive both radiotherapy and chemotherapy. The objective of the treatment is to free the patients of the disease and enable them to live longer [4][5][6][7][8]. According to the study of Obermair et al the 5-year survival rate for cervical cancer patients, who received radiotherapy together with chemotherapy, was 78.7% [7].…”