Hemoglobin level as the prognostic factor for patients with carcinoma cervix receiving radiation therapy

Abstract

Abstract
Objective: The primary objective was to assess the effect of pretreatment and mid treatment haemoglobin (Hb) level on local control, pelvic disease free and overall disease free survival.
Material and Methods

Seventy-two patients with Carcinoma Cervix referred for radiation therapy between January and December 2002 were entered into this prospective study. Forty-three (59%) patients had stage II disease and 29 (41%) had stage III disease. Hb levels were checked before starting treatment and in the middle of treatment. The mean Hb levels at the start and mid treatment were 12.8gm /dl and 12.1 gm/dl, respectively.

Results
Thirteen patients had treatment failures (pelvic 9, distant 3 and 1 pelvic and distant). Patients with mid treatment Hb levels of ≥12gm/dl had significantly lower pelvic failures (p=0.05) as well as overall failures (0.03) in comparison to patients with Hb levels of < 12gm/dl. The patients with mid treatment Hb level ≥ 12gm/dl had 5-year pelvic disease free survival and overall disease free survival of 83% and 81% as compared to 66% and 58% for patients with Hb <12gm/dl (p=0.04 and p=0.02). The 5-year pelvic disease free survival for stage II was 89% compared with 45% for stage III (p=0.006).
Conclusion
A mid treatment Hb level of ≥12gm/dl had significantly higher pelvic control and 5-year pelvic disease free survival as well as overall survival. The stage of disease was an independent prognostic factor.