Pirus Ghadjar1, Christoph Pöttgen2, Daniela Joos3,2, Stefanie Hayoz4, Michael Baumann5, Stephan Bodis6, Wilfried Budach7, Gabriela Studer8, Carmen Stromberger3, Frank Zimmermann9, David Kaul3, Ludwig Plasswilm10, Heidi Olze11, Jacques Bernier12, Peter Wust3, Daniel M Aebersold13, Volker Budach3. 1. Departments of Radiation Oncology, Charité Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. pirus.ghadjar@charite.de. 2. University Hospital Essen, Essen, Germany. 3. Departments of Radiation Oncology, Charité Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. 4. SAKK Coordinating Center, Bern, Switzerland. 5. Medical Faculty and University Hospital, Technische Universität Dresden, Dresden, Germany. 6. Kantonsspital Aarau, Aarau, Switzerland. 7. Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany. 8. University Hospital Zürich, Zürich, Switzerland. 9. University Hospital Basel, Basel, Switzerland. 10. Kantonsspital St. Gallen, St. Gallen, Switzerland. 11. Department for Head and Neck Surgery, Charité Universitaetsmedizin Berlin, Berlin, Germany. 12. Clinique de Genolier, Genolier, Switzerland. 13. Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
Abstract
BACKGROUND: To determine the influence of baseline laboratory values on treatment outcome in patients with locally advanced head and neck cancer (HNSCC). METHODS: Data of the randomized trials ARO 95 -06 (n = 384) and SAKK 10 /94 (n = 224) were pooled for a total sample size of 608 patients. Haemoglobin (Hb) and creatinine (Cr) were available at baseline and their association with locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), cancer-specific survival (CSS), and overall survival (OS) was analyzed using univariable and multivariable Cox regression models. RESULTS:A total of 580 and 564 patients were available with baseline Hb and Cr values in the pooled analysis. Univariable analyses revealed that lower baseline Hb values were significantly associated with decreased LRRFS, DMFS, CSS and OS. This effect remained significant for OS when the treatment arms (radiotherapy [RT] alone vs. chemoradiation [CRT]) were analyzed separately. Higher baseline Cr was associated with improved OS in the pooled analysis. Interestingly, the prognostic value of baseline Cr appeared to be limited to the subgroup of 284 patients who were treated with CRT. In the multivariable Cox regression model lower baseline Hb remained associated with decreased OS both in the patients who received CRT (HR 0.79, 95 % CI 0.66-0.94, p = 0.009) and in those patients who underwent RT alone (HR 0.67, 95 % CI 0.58-0.78, p < 0.001). Increased baseline Cr remained significantly associated with improved OS in patients who underwent CRT (HR 0.79, 95 % CI 0.69-0.92, p = 0.002) but not in those patients who underwent RT alone. CONCLUSIONS: An association between lower baseline Hb and inferior treatment outcome was confirmed. Baseline Cr was introduced as a prognosticator of outcome after CRT for locally advanced HNSCC.
RCT Entities:
BACKGROUND: To determine the influence of baseline laboratory values on treatment outcome in patients with locally advanced head and neck cancer (HNSCC). METHODS: Data of the randomized trials ARO 95 -06 (n = 384) and SAKK 10 /94 (n = 224) were pooled for a total sample size of 608 patients. Haemoglobin (Hb) and creatinine (Cr) were available at baseline and their association with locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), cancer-specific survival (CSS), and overall survival (OS) was analyzed using univariable and multivariable Cox regression models. RESULTS: A total of 580 and 564 patients were available with baseline Hb and Cr values in the pooled analysis. Univariable analyses revealed that lower baseline Hb values were significantly associated with decreased LRRFS, DMFS, CSS and OS. This effect remained significant for OS when the treatment arms (radiotherapy [RT] alone vs. chemoradiation [CRT]) were analyzed separately. Higher baseline Cr was associated with improved OS in the pooled analysis. Interestingly, the prognostic value of baseline Cr appeared to be limited to the subgroup of 284 patients who were treated with CRT. In the multivariable Cox regression model lower baseline Hb remained associated with decreased OS both in the patients who received CRT (HR 0.79, 95 % CI 0.66-0.94, p = 0.009) and in those patients who underwent RT alone (HR 0.67, 95 % CI 0.58-0.78, p < 0.001). Increased baseline Cr remained significantly associated with improved OS in patients who underwent CRT (HR 0.79, 95 % CI 0.69-0.92, p = 0.002) but not in those patients who underwent RT alone. CONCLUSIONS: An association between lower baseline Hb and inferior treatment outcome was confirmed. Baseline Cr was introduced as a prognosticator of outcome after CRT for locally advanced HNSCC.
Entities:
Keywords:
Carcinoma, squamous cell of head and neck; Chemotherapy; Creatinine; Hemoglobin; Radiation therapy
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