Abstract
Purpose: The aim of the study is to investigate the correlation between hemoglobin level during chemoradiation therapy and overall survival in nasopharyngeal cancer. Materials and Methods: Between December 2006 and March 2010, patients with nonmetastatic nasopharyngeal cancer were enrolled. Radiation consisted of at least 70 Gy to the planning target volumes of primary tumor plus any positive nodal disease using 1.8 Gy to 2.0 Gy per fraction. Most patients (79.7%) received concurrent cisplatinbased chemotherapy with or without induction chemotherapy. Induction chemotherapy regimens, EP-HDFL, consisted of Epirubicin, Cisplatin, 5-FU, and Leucovorin. Concurrent chemotherapy, PFL, consisted of Cisplatin, 5-FU, and Leucovorin. Weekly hemoglobin levels during induction chemotherapy and/or concurrent chemoradiation therapy were checked for evaluation of hematological effects. Results: Total 64 patients were enrolled with a median follow-up of 56 months. AJCC stage III and IV predicted worse 5-year overall survival rates, 88.5% and 58.3%, respectively. Both grade 2 anemia in induction chemotherapy and grade 3 anemia in concurrent chemotherapy correlated with worse 5-year overall survival rates, 50.0% and 50.0%, respectively. No grade 4 or 5 anemia occurred in this study. The effect of anemia had a trend toward significance in univariate analysis. Conclusion: Besides AJCC staging, weekly hemoglobin levels during induction chemotherapy and/or concurrent chemoradiation therapy is a potentially clinical predictor of long-term treatment outcome in nasopharyngeal cancer.
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