Influence of anaemia in patients with head and neck cancer receiving adjuvant postoperative radiotherapy in the Grampian region.

AIMS: To assess the impact of haemoglobin on local recurrence and overall survival in patients receiving postoperative radiotherapy for squamous cell carcinoma of the head and neck.

MATERIALS AND

METHODS

A retrospective study identified all patients with head and neck carcinoma treated with primary surgery followed by adjuvant radiotherapy from 1994-2000. Data were collected on host-related, tumour-related and treatment-related factors, and outcome was measured in terms of time to local recurrence and overall survival.

RESULTS

Ninety-five patients were identified for analysis. The median age was 58.5 years; 31% were women. Mean pre-treatment haemoglobin was 128 g/l. The primary site of tumour was in the oral cavity in 35% of patients, oropharynx in 20%, larynx in 20% and hypopharynx in 5% of patients. Nodal involvement was seen in 48% of patients. A median biologically effective dose (BED) of 62.5 Gy10 was delivered, with a median overall treatment time of 26 days. After a median follow-up of 3.1 years, 23% of patients had local recurrence and 48% had died, with an estimated median survival time of 5.6 years. Actuarial 2-year and 5-year local control rates were both 75%, and actuarial 2-year and 5-year survival rates were 67% and 51%, respectively. Multivariate analysis revealed T stage, margin status, BED and anaemia to be independent prognostic factors, and T stage, N stage, tumour site, BED and anaemia to be independent predictors for local recurrence.

CONCLUSION

The data from this study are consistent with the hypothesis that pre-treatment anaemia is an independent prognostic factor for survival and predictive factor for local recurrence in postoperative radiotherapy for head and neck cancer.