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Anemia During Sequential Induction Chemotherapy and Chemoradiation for Head and Neck Cancer: The Impact of Blood Transfusion on Treatment Outcome

Abstract

Purpose: Sequential treatment (chemotherapy followed by concomitant chemoradiation; CCRT) is increasingly being used for radical treatment of squamous cell cancer of the head and neck (SCCHN), which results in increased myelosuppression. In this study, we review the incidence of anemia and the effect of a policy of hemoglobin (Hb) maintenance by blood transfusion on disease outcomes in these patients. Methods and Materials: Retrospective review of the records of patients with SCCHN treated with sequential CCRT formed the basis of this study. The incidence of anemia and statistics on blood transfusion were documented. For the purpose of outcome analyses, patients were divided into four categories by (1) transfusion status, (2) nadir Hb concentration, (3) number of transfusion episodes, and (4) number of units of blood transfused (NOUT). Data on 3-year locoregional control (LRC), relapse-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) were analyzed. Results: One hundred and sixty-nine patients were identified. The median follow-up was 23.6 months. The RFS (52% vs. 41%, p = 0.03), DSS (71% vs. 66%, p = 0.02), and OS (58% vs. 42% p = 0.005) were significantly better for patients who did not have a transfusion vs. those who did. The LRC, RFS, DSS,  More>>
Publication Date:
Feb 01, 2009
Product Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 73; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2008.04.052; PII: S0360-3016(08)00809-2; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANEMIAS; BLOOD; CARCINOMAS; CHEMOTHERAPY; HEAD; HEMOGLOBIN; NECK; PATIENTS; REVIEWS; TRANSFUSIONS
OSTI ID:
21172580
Country of Origin:
United States
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0360-3016; IOBPD3; TRN: US09R0563047759
Availability:
Available from http://dx.doi.org/10.1016/j.ijrobp.2008.04.052;INIS
Submitting Site:
INIS
Size:
page(s) 391-398
Announcement Date:
Jun 18, 2009

Citation Formats

Bhide, Shreerang A, Ahmed, Merina, Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom)], Rengarajan, Vijayan, Powell, Ceri, Miah, Aisha, Newbold, Kate, Nutting, Christopher M, Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom)], Harrington, Kevin J, and Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom)], E-mail: kevinh@icr.ac.uk. Anemia During Sequential Induction Chemotherapy and Chemoradiation for Head and Neck Cancer: The Impact of Blood Transfusion on Treatment Outcome. United States: N. p., 2009. Web. doi:10.1016/j.ijrobp.2008.04.052.
Bhide, Shreerang A, Ahmed, Merina, Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom)], Rengarajan, Vijayan, Powell, Ceri, Miah, Aisha, Newbold, Kate, Nutting, Christopher M, Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom)], Harrington, Kevin J, & Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom)], E-mail: kevinh@icr.ac.uk. Anemia During Sequential Induction Chemotherapy and Chemoradiation for Head and Neck Cancer: The Impact of Blood Transfusion on Treatment Outcome. United States. https://doi.org/10.1016/j.ijrobp.2008.04.052
Bhide, Shreerang A, Ahmed, Merina, Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom)], Rengarajan, Vijayan, Powell, Ceri, Miah, Aisha, Newbold, Kate, Nutting, Christopher M, Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom)], Harrington, Kevin J, and Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom)], E-mail: kevinh@icr.ac.uk. 2009. "Anemia During Sequential Induction Chemotherapy and Chemoradiation for Head and Neck Cancer: The Impact of Blood Transfusion on Treatment Outcome." United States. https://doi.org/10.1016/j.ijrobp.2008.04.052.
@misc{etde_21172580,
title = {Anemia During Sequential Induction Chemotherapy and Chemoradiation for Head and Neck Cancer: The Impact of Blood Transfusion on Treatment Outcome}
author = {Bhide, Shreerang A, Ahmed, Merina, Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom)], Rengarajan, Vijayan, Powell, Ceri, Miah, Aisha, Newbold, Kate, Nutting, Christopher M, Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom)], Harrington, Kevin J, and Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom)], E-mail: kevinh@icr.ac.uk}
abstractNote = {Purpose: Sequential treatment (chemotherapy followed by concomitant chemoradiation; CCRT) is increasingly being used for radical treatment of squamous cell cancer of the head and neck (SCCHN), which results in increased myelosuppression. In this study, we review the incidence of anemia and the effect of a policy of hemoglobin (Hb) maintenance by blood transfusion on disease outcomes in these patients. Methods and Materials: Retrospective review of the records of patients with SCCHN treated with sequential CCRT formed the basis of this study. The incidence of anemia and statistics on blood transfusion were documented. For the purpose of outcome analyses, patients were divided into four categories by (1) transfusion status, (2) nadir Hb concentration, (3) number of transfusion episodes, and (4) number of units of blood transfused (NOUT). Data on 3-year locoregional control (LRC), relapse-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) were analyzed. Results: One hundred and sixty-nine patients were identified. The median follow-up was 23.6 months. The RFS (52% vs. 41%, p = 0.03), DSS (71% vs. 66%, p = 0.02), and OS (58% vs. 42% p = 0.005) were significantly better for patients who did not have a transfusion vs. those who did. The LRC, RFS, DSS, and OS were also significantly better for patients with nadir Hb level >12 vs. <12 g/dL and NOUT 1-4 vs. >4. Conclusion: Our study seems to suggest that blood transfusion during radical treatment for SCCHN might be detrimental. Further research should be undertaken into the complex interactions among tumor hypoxia, anemia, and the treatment of anemia before making treatment recommendations.}
doi = {10.1016/j.ijrobp.2008.04.052}
journal = []
issue = {2}
volume = {73}
place = {United States}
year = {2009}
month = {Feb}
}