Pre-treatment anaemia alters outcome in early squamous cell carcinoma of the larynx treated by radical radiotherapy

Abstract

The purpose of this study was to examine the effect of pre-treatment anaemia on tumour recurrence and survival in patients treated with primary radiotherapy for early squamous cell carcinoma of the larynx. A retrospective analysis of 117 patients with previously untreated T1N0M0 and T2N0M0 squamous cell carcinoma of the larynx was carried out. Patients were considered anaemic if their pre-treatment haemoglobin levels were below 13 g/dl in males and 11.5 g/dl in females. The influence of pre-treatment haemoglobin levels on local control and survival were evaluated using Cox proportional hazards regression models. Two- and five-year local-regional control estimates for anaemic patients were 58 per cent and 53 per cent respectively while patients with normal haemoglobin levels had two and five-year local-regional control rates of 90 per cent and 81 per cent respectively (p = 0.002). Multivariate Cox regression analysis showed pre-treatment haemoglobin significantly influencing recurrence-free survival (p = 0.0094). Patients with a low haemoglobin level prior to radiation therapy suffered higher levels of local-regional failure.