Significant prognostic impact of chemoradiotherapy-induced hemoglobin decrease on treatment outcomes of nasopharyngeal carcinoma. Liang, X., Li, Q., Su, Z., Lan, X., Ouyang, P., Mao, Y., Shi, D., Deng, W., Cheng, Z., Wang, S., & Xie, F. Journal of Cancer, 6(6):502–510, 2015. doi abstract bibtex PURPOSE To investigate prognostic impact of chemoradiotherapy-induced hemoglobin (Hb) decrease on treatment outcomes of endemic nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS Eight hundred and fifteen non-metastatic NPC, receiving neoadjuvant chemotherapy followed by radiotherapy (NACT+RT group) or concomitant chemoradiotherapy (CCRT group), were enrolled in this study, who were regrouped according to pre-radiotherapy Hb (pre-RT Hb), post-radiotherapy Hb (post-RT Hb) and individual Hb decrease through radiotherapy or CCRT (△Hb), respectively. Survival curves were estimated using Kaplan-Meier method and compared by log-rank test. Multivariate analysis was performed using the COX proportional hazard model and binary logistic regression model. RESULTS A poorer 5-year disease-free survival (DFS) was observed when pre-RT Hb\textless130.00 g/L. However, post-RT Hb\textless130.00 g/L was associated with significantly poorer 5-year locoregional recurrence-free survival (LRFS) (P=0.010) and disease specific survival (DSS) (P=0.008). Multivariate analysis with the COX proportional hazard model identified post-RT Hb\textless130.00 g/L as an independent negative prognostic factor for both LRFS (hazard ratio [HR], 1.896; 95% confidence interval [CI], 1.158-3.106; P=0.011) and DSS (HR, 1.767; 95% CI, 1.152-2.711; P=0.009). Similarly, △Hb \textless-15.00 g/L also predicted poorer 5-year LRFS (P=0.024) and DSS (P=0.015), which was confirmed in multivariate analysis as an independent adverse prognostic factor for LRFS (HR, 1.586; 95% CI, 1.058-2.377; P=0.026) and DSS (HR, 1.556; 95% CI, 1.087-2.227; P=0.016), respectively. Multivariate analysis with binary logistic regression model indicated that CCRT was a significantly independent predictor for post-RT Hb \textless130.00 g/L and △Hb \textless -15.00 g/L. CONCLUSIONS Chemoradiotherapy-induced decreased Hb levels have negative influence on locoregional control and survival, and might counteract the benefit of neoadjuvant/concomitant chemotherapy. Further studies on supportive care to maintain sufficient Hb level during chemo-radiotherapy are warranted.
@article{liang_significant_2015,
title = {Significant prognostic impact of chemoradiotherapy-induced hemoglobin decrease on treatment outcomes of nasopharyngeal carcinoma},
volume = {6},
issn = {1837-9664},
doi = {10.7150/jca.11403},
abstract = {PURPOSE
To investigate prognostic impact of chemoradiotherapy-induced hemoglobin (Hb) decrease on treatment outcomes of endemic nasopharyngeal carcinoma (NPC).
MATERIALS AND METHODS
Eight hundred and fifteen non-metastatic NPC, receiving neoadjuvant chemotherapy followed by radiotherapy (NACT+RT group) or concomitant chemoradiotherapy (CCRT group), were enrolled in this study, who were regrouped according to pre-radiotherapy Hb (pre-RT Hb), post-radiotherapy Hb (post-RT Hb) and individual Hb decrease through radiotherapy or CCRT (△Hb), respectively. Survival curves were estimated using Kaplan-Meier method and compared by log-rank test. Multivariate analysis was performed using the COX proportional hazard model and binary logistic regression model.
RESULTS
A poorer 5-year disease-free survival (DFS) was observed when pre-RT Hb{\textless}130.00 g/L. However, post-RT Hb{\textless}130.00 g/L was associated with significantly poorer 5-year locoregional recurrence-free survival (LRFS) (P=0.010) and disease specific survival (DSS) (P=0.008). Multivariate analysis with the COX proportional hazard model identified post-RT Hb{\textless}130.00 g/L as an independent negative prognostic factor for both LRFS (hazard ratio [HR], 1.896; 95\% confidence interval [CI], 1.158-3.106; P=0.011) and DSS (HR, 1.767; 95\% CI, 1.152-2.711; P=0.009). Similarly, △Hb {\textless}-15.00 g/L also predicted poorer 5-year LRFS (P=0.024) and DSS (P=0.015), which was confirmed in multivariate analysis as an independent adverse prognostic factor for LRFS (HR, 1.586; 95\% CI, 1.058-2.377; P=0.026) and DSS (HR, 1.556; 95\% CI, 1.087-2.227; P=0.016), respectively. Multivariate analysis with binary logistic regression model indicated that CCRT was a significantly independent predictor for post-RT Hb {\textless}130.00 g/L and △Hb {\textless} -15.00 g/L.
CONCLUSIONS
Chemoradiotherapy-induced decreased Hb levels have negative influence on locoregional control and survival, and might counteract the benefit of neoadjuvant/concomitant chemotherapy. Further studies on supportive care to maintain sufficient Hb level during chemo-radiotherapy are warranted.},
number = {6},
journal = {Journal of Cancer},
author = {Liang, Xue-Xia and Li, Qun and Su, Zhen and Lan, Xiao-Wen and Ouyang, Pu-Yun and Mao, Yan-Ping and Shi, Ding-Bo and Deng, Wu-Guo and Cheng, Zhi-Bin and Wang, Si-Yang and Xie, Fang-Yun},
year = {2015},
pmid = {26000040},
pages = {502--510}
}
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{"_id":"RSLLMKwaxZ8JX96L3","bibbaseid":"liang-li-su-lan-ouyang-mao-shi-deng-etal-significantprognosticimpactofchemoradiotherapyinducedhemoglobindecreaseontreatmentoutcomesofnasopharyngealcarcinoma-2015","authorIDs":[],"author_short":["Liang, X.","Li, Q.","Su, Z.","Lan, X.","Ouyang, P.","Mao, Y.","Shi, D.","Deng, W.","Cheng, Z.","Wang, S.","Xie, F."],"bibdata":{"bibtype":"article","type":"article","title":"Significant prognostic impact of chemoradiotherapy-induced hemoglobin decrease on treatment outcomes of nasopharyngeal carcinoma","volume":"6","issn":"1837-9664","doi":"10.7150/jca.11403","abstract":"PURPOSE To investigate prognostic impact of chemoradiotherapy-induced hemoglobin (Hb) decrease on treatment outcomes of endemic nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS Eight hundred and fifteen non-metastatic NPC, receiving neoadjuvant chemotherapy followed by radiotherapy (NACT+RT group) or concomitant chemoradiotherapy (CCRT group), were enrolled in this study, who were regrouped according to pre-radiotherapy Hb (pre-RT Hb), post-radiotherapy Hb (post-RT Hb) and individual Hb decrease through radiotherapy or CCRT (△Hb), respectively. Survival curves were estimated using Kaplan-Meier method and compared by log-rank test. Multivariate analysis was performed using the COX proportional hazard model and binary logistic regression model. RESULTS A poorer 5-year disease-free survival (DFS) was observed when pre-RT Hb\\textless130.00 g/L. However, post-RT Hb\\textless130.00 g/L was associated with significantly poorer 5-year locoregional recurrence-free survival (LRFS) (P=0.010) and disease specific survival (DSS) (P=0.008). Multivariate analysis with the COX proportional hazard model identified post-RT Hb\\textless130.00 g/L as an independent negative prognostic factor for both LRFS (hazard ratio [HR], 1.896; 95% confidence interval [CI], 1.158-3.106; P=0.011) and DSS (HR, 1.767; 95% CI, 1.152-2.711; P=0.009). Similarly, △Hb \\textless-15.00 g/L also predicted poorer 5-year LRFS (P=0.024) and DSS (P=0.015), which was confirmed in multivariate analysis as an independent adverse prognostic factor for LRFS (HR, 1.586; 95% CI, 1.058-2.377; P=0.026) and DSS (HR, 1.556; 95% CI, 1.087-2.227; P=0.016), respectively. Multivariate analysis with binary logistic regression model indicated that CCRT was a significantly independent predictor for post-RT Hb \\textless130.00 g/L and △Hb \\textless -15.00 g/L. CONCLUSIONS Chemoradiotherapy-induced decreased Hb levels have negative influence on locoregional control and survival, and might counteract the benefit of neoadjuvant/concomitant chemotherapy. Further studies on supportive care to maintain sufficient Hb level during chemo-radiotherapy are warranted.","number":"6","journal":"Journal of Cancer","author":[{"propositions":[],"lastnames":["Liang"],"firstnames":["Xue-Xia"],"suffixes":[]},{"propositions":[],"lastnames":["Li"],"firstnames":["Qun"],"suffixes":[]},{"propositions":[],"lastnames":["Su"],"firstnames":["Zhen"],"suffixes":[]},{"propositions":[],"lastnames":["Lan"],"firstnames":["Xiao-Wen"],"suffixes":[]},{"propositions":[],"lastnames":["Ouyang"],"firstnames":["Pu-Yun"],"suffixes":[]},{"propositions":[],"lastnames":["Mao"],"firstnames":["Yan-Ping"],"suffixes":[]},{"propositions":[],"lastnames":["Shi"],"firstnames":["Ding-Bo"],"suffixes":[]},{"propositions":[],"lastnames":["Deng"],"firstnames":["Wu-Guo"],"suffixes":[]},{"propositions":[],"lastnames":["Cheng"],"firstnames":["Zhi-Bin"],"suffixes":[]},{"propositions":[],"lastnames":["Wang"],"firstnames":["Si-Yang"],"suffixes":[]},{"propositions":[],"lastnames":["Xie"],"firstnames":["Fang-Yun"],"suffixes":[]}],"year":"2015","pmid":"26000040","pages":"502–510","bibtex":"@article{liang_significant_2015,\n\ttitle = {Significant prognostic impact of chemoradiotherapy-induced hemoglobin decrease on treatment outcomes of nasopharyngeal carcinoma},\n\tvolume = {6},\n\tissn = {1837-9664},\n\tdoi = {10.7150/jca.11403},\n\tabstract = {PURPOSE\n\nTo investigate prognostic impact of chemoradiotherapy-induced hemoglobin (Hb) decrease on treatment outcomes of endemic nasopharyngeal carcinoma (NPC).\n\n\nMATERIALS AND METHODS\n\nEight hundred and fifteen non-metastatic NPC, receiving neoadjuvant chemotherapy followed by radiotherapy (NACT+RT group) or concomitant chemoradiotherapy (CCRT group), were enrolled in this study, who were regrouped according to pre-radiotherapy Hb (pre-RT Hb), post-radiotherapy Hb (post-RT Hb) and individual Hb decrease through radiotherapy or CCRT (△Hb), respectively. Survival curves were estimated using Kaplan-Meier method and compared by log-rank test. Multivariate analysis was performed using the COX proportional hazard model and binary logistic regression model.\n\n\nRESULTS\n\nA poorer 5-year disease-free survival (DFS) was observed when pre-RT Hb{\\textless}130.00 g/L. However, post-RT Hb{\\textless}130.00 g/L was associated with significantly poorer 5-year locoregional recurrence-free survival (LRFS) (P=0.010) and disease specific survival (DSS) (P=0.008). Multivariate analysis with the COX proportional hazard model identified post-RT Hb{\\textless}130.00 g/L as an independent negative prognostic factor for both LRFS (hazard ratio [HR], 1.896; 95\\% confidence interval [CI], 1.158-3.106; P=0.011) and DSS (HR, 1.767; 95\\% CI, 1.152-2.711; P=0.009). Similarly, △Hb {\\textless}-15.00 g/L also predicted poorer 5-year LRFS (P=0.024) and DSS (P=0.015), which was confirmed in multivariate analysis as an independent adverse prognostic factor for LRFS (HR, 1.586; 95\\% CI, 1.058-2.377; P=0.026) and DSS (HR, 1.556; 95\\% CI, 1.087-2.227; P=0.016), respectively. Multivariate analysis with binary logistic regression model indicated that CCRT was a significantly independent predictor for post-RT Hb {\\textless}130.00 g/L and △Hb {\\textless} -15.00 g/L.\n\n\nCONCLUSIONS\n\nChemoradiotherapy-induced decreased Hb levels have negative influence on locoregional control and survival, and might counteract the benefit of neoadjuvant/concomitant chemotherapy. Further studies on supportive care to maintain sufficient Hb level during chemo-radiotherapy are warranted.},\n\tnumber = {6},\n\tjournal = {Journal of Cancer},\n\tauthor = {Liang, Xue-Xia and Li, Qun and Su, Zhen and Lan, Xiao-Wen and Ouyang, Pu-Yun and Mao, Yan-Ping and Shi, Ding-Bo and Deng, Wu-Guo and Cheng, Zhi-Bin and Wang, Si-Yang and Xie, Fang-Yun},\n\tyear = {2015},\n\tpmid = {26000040},\n\tpages = {502--510}\n}\n\n","author_short":["Liang, X.","Li, Q.","Su, Z.","Lan, X.","Ouyang, P.","Mao, Y.","Shi, D.","Deng, W.","Cheng, Z.","Wang, S.","Xie, F."],"key":"liang_significant_2015","id":"liang_significant_2015","bibbaseid":"liang-li-su-lan-ouyang-mao-shi-deng-etal-significantprognosticimpactofchemoradiotherapyinducedhemoglobindecreaseontreatmentoutcomesofnasopharyngealcarcinoma-2015","role":"author","urls":{},"downloads":0},"bibtype":"article","biburl":"https://api.zotero.org/users/585595/collections/74C3SXBK/items?key=1nXMl6HeUfXzWafuqAa4Ryj2&format=bibtex&limit=100\"></iframe","creationDate":"2019-05-09T15:52:34.269Z","downloads":0,"keywords":[],"search_terms":["significant","prognostic","impact","chemoradiotherapy","induced","hemoglobin","decrease","treatment","outcomes","nasopharyngeal","carcinoma","liang","li","su","lan","ouyang","mao","shi","deng","cheng","wang","xie"],"title":"Significant prognostic impact of chemoradiotherapy-induced hemoglobin decrease on treatment outcomes of nasopharyngeal carcinoma","year":2015,"dataSources":["Eax3HqcG6fcDtsCq9"]}