Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Tumor Biology
Published in: Tumor Biology 2/2016

01-02-2016 | Original Article

Pretreatment anemia and survival in nasopharyngeal carcinoma

Authors: Lu-Ning Zhang, Jie Tang, Xiao-Wen Lan, Pu-Yun OuYang, Fang-Yun Xie

Published in: Tumor Biology | Issue 2/2016

Login to get access

Abstract

Due to the low incidence of pretreatment anemia in nasopharyngeal carcinoma (NPC), the true prognostic impact of pretreatment anemia may be underestimated before. We retrospectively analyzed the association of pretreatment anemia with disease-specific survival (DSS), distant-metastasis-free survival (DMFS), and locoregional-relapse-free survival (LRFS) by Cox regression in a cohort of 5830 patients, stratifying by midtreatment anemia, smoking, body mass index (BMI), etc. Pretreatment anemia was significantly associated with adverse DSS (hazard ratio (HR) = 2.15, 95 % confidence interval (CI) 1.62–2.85, P < 0.001) and DMFS (HR = 1.53, 95 % CI 1.08–2.17, P = 0.018), comparing to patients with normal hemoglobin, after adjusting for covariates. Moreover, the association with DSS remained unchanged regardless of smoking status and clinical stage, whereas it was limited in the subgroups of above 45 years, male sex, and BMI <25 kg/m2. With restriction to midtreatment anemic patients, pretreatment anemia was still strongly correlated with inferior DSS and DMFS. This study, in the largest reported cohort, is the first to show the adverse prognostic impact of pretreatment anemia on DSS and DMFS in NPC.
Literature
1.
2.
OuYang PY, Xie C, Mao YP, Zhang Y, Liang XX, Su Z, et al. Significant efficacies of neoadjuvant and adjuvant chemotherapy for nasopharyngeal carcinoma by meta-analysis of published literature-based randomized, controlled trials. Ann Oncol. 2013;24:2136–46.CrossRefPubMed
3.
Baujat B, Audry H, Bourhis J, Chan AT, Onat H, Chua DT, et al. Chemotherapy in locally advanced nasopharyngeal carcinoma: an individual patient data meta-analysis of eight randomized trials and 1753 patients. Int J Radiat Oncol Biol Phys. 2006;64:47–56.CrossRefPubMed
4.
Sun X, Su S, Chen C, Han F, Zhao C, Xiao W, et al. Long-term outcomes of intensity-modulated radiotherapy for 868 patients with nasopharyngeal carcinoma: an analysis of survival and treatment toxicities. Radiother Oncol. 2014;110:398–403.CrossRefPubMed
5.
6.
Cosse JP, Michiels C. Tumour hypoxia affects the responsiveness of cancer cells to chemotherapy and promotes cancer progression. Anticancer Agents Med Chem. 2008;8:790–7.CrossRefPubMed
7.
Vaupel P, Mayer A, Hockel M. Impact of hemoglobin levels on tumor oxygenation: the higher, the better? Strahlenther Onkol. 2006;182:63–71.CrossRefPubMed
8.
Hoskin PJ, Rojas AM, Peiris SN, Mullassery V, Chong IY. Pre-treatment haemoglobin and peripheral blood lymphocyte count as independent predictors of outcome in carcinoma of cervix. Clin Oncol (R Coll Radiol). 2014;26:179–84.CrossRef
9.
Seo Y, Yoo SY, Kim M-S, Yang KM, Yoo HJ, Kim JH, et al. Nomogram prediction of overall survival after curative irradiation for uterine cervical cancer. Int J Radiat Oncol Biol Phys. 2011;79:782–7.CrossRefPubMed
10.
Rades D, Stoehr M, Kazic N, Hakim SG, Walz A, Schild SE, et al. Locally advanced stage IV squamous cell carcinoma of the head and neck: impact of pre-radiotherapy hemoglobin level and interruptions during radiotherapy. Int J Radiat Oncol Biol Phys. 2008;70:1108–14.CrossRefPubMed
11.
Fortin A, Wang CS, Vigneault E. Effect of pretreatment anemia on treatment outcome of concurrent radiochemotherapy in patients with head and neck cancer. Int J Radiat Oncol Biol Phys. 2008;72:255–60.CrossRefPubMed
12.
Schafer U, Micke O, Muller SB, Schuller P, Willich N. Hemoglobin as an independent prognostic factor in the radiotherapy of head and neck tumors. Strahlenther Onkol. 2003;179:527–34.CrossRefPubMed
13.
Chua DT, Sham JS, Choy DT. Prognostic impact of hemoglobin levels on treatment outcome in patients with nasopharyngeal carcinoma treated with sequential chemoradiotherapy or radiotherapy alone. Cancer. 2004;101:307–16.CrossRefPubMed
14.
Gao J, Hu JY, Xia YF, Yi W, Tao YL, Li G. Continuous fall in hemoglobin level is a poor prognostic factor in patients with nasopharyngeal carcinoma treated with radiotherapy. Chin J Cancer. 2010;29:561–6.CrossRefPubMed
15.
Gao J, Tao YL, Li G, Yi W, Xia YF. Involvement of difference in decrease of hemoglobin level in poor prognosis of stage I and II nasopharyngeal carcinoma: implication in outcome of radiotherapy. Int J Radiat Oncol Biol Phys. 2012;82:1471–8.CrossRefPubMed
16.
Jensen JA, Goodson WH, Hopf HW, Hunt TK. Cigarette smoking decreases tissue oxygen. Arch Surg. 1991;126:1131–4.CrossRefPubMed
17.
Grau C, Nordsmark M, Khalil AA, Horsman MR, Overgaard J. Effect of carbon monoxide breathing on hypoxia and radiation response in the SCCVII tumor in vivo. Int J Radiat Oncol Biol Phys. 1994;29:449–54.CrossRefPubMed
18.
Hoff CM, Grau C, Overgaard J. Effect of smoking on oxygen delivery and outcome in patients treated with radiotherapy for head and neck squamous cell carcinoma—a prospective study. Radiother Oncol. 2012;103:38–44.CrossRefPubMed
19.
Chen C, Shen LJ, Li BF, Gao J, Xia YF. Smoking is a poor prognostic factor for male nasopharyngeal carcinoma treated with radiotherapy. Radiother Oncol. 2014;110:409–15.CrossRefPubMed
20.
Ouyang PY, Su Z, Mao YP, Liang XX, Liu Q, Deng W, et al. Prognostic impact of cigarette smoking on the survival of patients with established nasopharyngeal carcinoma. Cancer Epidemiol Biomarkers Prev. 2013;22:2285–94.CrossRefPubMed
21.
Huang PY, Wang CT, Cao KJ, Guo X, Guo L, Mo HY, et al. Pretreatment body mass index as an independent prognostic factor in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy: findings from a randomised trial. Eur J Cancer. 2013;49:1923–31.CrossRefPubMed
22.
Lai SZ, Li WF, Chen L, Luo W, Chen YY, Liu LZ, et al. How does intensity-modulated radiotherapy versus conventional two-dimensional radiotherapy influence the treatment results in nasopharyngeal carcinoma patients? Int J Radiat Oncol Biol Phys. 2011;80:661–8.CrossRefPubMed
23.
24.
25.
Ouyang PY, Su Z, Mao YP, Liang XX, Liu Q, Xie FY. Prognostic impact of family history in southern Chinese patients with undifferentiated nasopharyngeal carcinoma. Br J Cancer. 2013;109:788–94.CrossRefPubMedPubMedCentral
26.
Liu N, Chen NY, Cui RX, Li WF, Li Y, Wei RR, et al. Prognostic value of a microRNA signature in nasopharyngeal carcinoma: a microRNA expression analysis. Lancet Oncol. 2012;13:633–41.CrossRefPubMed
27.
Kaplan EL, Meier P. Nonparametric estimation from incomplete observation. J Am Stat Assoc. 1958;53:457–81.CrossRef
28.
Cox DR. Regression models and life tables. J R Stat Soc B. 1972;34:187–220.
29.
Zhang S, Lu M, Li Y, Li J, Shen L. A lower haemoglobin level predicts a worse survival of patients with advanced gastric cancer. Clin Oncol (R Coll Radiol). 2014;26:239–40.CrossRef
30.
Finkelmeier F, Bettinger D, Koberle V, Schultheiss M, Zeuzem S, Kronenberger B, et al. Single measurement of hemoglobin predicts outcome of HCC patients. Med Oncol. 2014;31:806.CrossRefPubMed
31.
Henke M, Sindlinger F, Ikenberg H, Gerds T, Schumacher M. Blood hemoglobin level and treatment outcome of early breast cancer. Strahlenther Onkol. 2004;180:45–51.CrossRefPubMed
32.
Shen GP, Xu FH, He F, Ruan HL, Cui C, Chen LZ, et al. Pretreatment lifestyle behaviors as survival predictors for patients with nasopharyngeal carcinoma. PLoS ONE. 2012;7:e36515.CrossRefPubMedPubMedCentral
33.
34.
OuYang PY, Zhang LN, Lan XW, Xie C, Zhang WW, Wang QX, et al. The significant survival advantage of female sex in nasopharyngeal carcinoma: a propensity-matched analysis. Br J Cancer. 2015;112:1554–61.CrossRefPubMedPubMedCentral
Metadata
Title
Pretreatment anemia and survival in nasopharyngeal carcinoma
Authors
Lu-Ning Zhang
Jie Tang
Xiao-Wen Lan
Pu-Yun OuYang
Fang-Yun Xie
Publication date
01-02-2016
Publisher
Springer Netherlands
Published in
Tumor Biology / Issue 2/2016
Print ISSN: 1010-4283
Electronic ISSN: 1423-0380
DOI
https://doi.org/10.1007/s13277-015-4042-6

Other articles of this Issue 2/2016

Tumor Biology 2/2016 Go to the issue

Original Article

Low-level expression of microRNA-375 predicts poor prognosis in hepatocellular carcinoma

OriginalPaper

Identification of novel therapeutic target genes in acquired lapatinib-resistant breast cancer by integrative meta-analysis

Original Article

CpG methylation of ubiquitin carboxyl-terminal hydrolase 1 (UCHL1) and P53 mutation pattern in sporadic colorectal cancer

Original Article

Identification of expression quantitative trait loci of RPTOR for susceptibility to glioma

Original Article

A new insight into cancer stem cell markers: Could local and circulating cancer stem cell markers correlate in colorectal cancer?

Original Article

Lysophosphatidic acid induces both EGFR-dependent and EGFR-independent effects on DNA synthesis and migration in pancreatic and colorectal carcinoma cells
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits