Radiotherapy With or Without Erythropoietin for Anemic Patients With Head and Neck Cancer: A Randomized Trial of the Radiation Therapy Oncology Group (RTOG 99-03)
- Thomas Jefferson University College of Medicine, Philadelphia, PA (United States)
- Radiation Therapy Oncology Group Statistical Headquarters, Philadelphia, PA (United States)
- University of Maryland School of Medicine, Baltimore, MD (United States)
- McGill University Medical School, Montreal, Quebec (Canada)
- University of Pennsylvania Medical Center, Philadelphia, PA (United States)
- Vanderbilt University Medical Center, Nashville, TN (United States)
- Downstate Medical Center/State University of New York, Brooklyn, NY (United States)
- University of California, San Francisco Medical Center, San Francisco, CA (United States)
Purpose: To determine whether the addition of recombinant human erythropoietin (Epo) could improve the outcomes of anemic patients receiving definitive radiotherapy for squamous cell carcinoma of the head and neck (SCCHN). Methods and Materials: Eligible patients had SCCHN, with a plan for continuous-course definitive radiotherapy (66-72 Gy) with or without chemotherapy. Patients with Stage III or IV SCCHN were required to undergo concurrent chemoradiotherapy and/or accelerated fractionation radiotherapy. Preradiotherapy hemoglobin was required to be between 9.0 g/dL and 13.5 g/dL (12.5 g/dL for women). Patients randomized to Epo received 40,000 U once weekly, starting 7-10 days before start of radiotherapy. Results: A total of 148 patients were enrolled; 141 were evaluable. Median pretreatment hemoglobin was 12.1 g/dL. Hemoglobin levels at 4 weeks rose by an average of 1.66 g/dL in the Epo arm, compared with an average 0.24 g/dL decrease in the control arm (p = 0.0001). Median follow-up was 2.5 years (3.1 years for surviving patients). There was no statistically significant difference in the primary endpoint of local-regional failure (LRF) rate between the treatment arms. The 3-year LRF rate was 36% for control and 44% for Epo (p = 0.56). There were also no significant differences in local-regional progression-free survival (LRPFS), patterns of failure, overall survival, or toxicity. The 3-year LRPFS rate was 52% for control and 47% for Epo. The overall survival rate was 57% and 56%, respectively. Conclusions: The addition of Epo to definitive radiotherapy for SCCHN did not improve outcomes. The study was not specifically designed to detect a potential negative association between Epo and tumor progression/survival.
- OSTI ID:
- 21039610
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 69, Issue 4; Other Information: DOI: 10.1016/j.ijrobp.2007.04.063; PII: S0360-3016(07)00757-2; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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