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Singuluri LS, Jayachandran PK, Goenka L, Shenoy PK, Rathnam KK, Seshachalam A, Mehra N, Kumar MR, Suseela MM, Raghavan V, Nair CK, Dubashi B, Dhanushkodi M, Ganesan P. Prognostic Factors and Outcomes of Early-Stage Hodgkin's Lymphoma: Multi-Institutional Data From South India. Indian J Hematol Blood Transfus 2024; 40:237-245. [PMID: 38708161 PMCID: PMC11065829 DOI: 10.1007/s12288-023-01692-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/10/2023] [Indexed: 05/07/2024] Open
Abstract
Early-stage Hodgkin's lymphoma (ESHL) is highly curable, usually with a combination of chemotherapy and radiation. Real-world data may show differences in survival and prognostic factors when compared to clinical trials. There is limited published literature on ESHL from India. The data on the baseline characters, treatment, and outcomes of patients with ESHL (stage IA, IB, and IIA) were obtained from five institutions' medical records and entered in a common database. Event-free survival (EFS) and overall survival (OS) were estimated using the Kaplan Meier method, and cox-regression analysis was used to identify prognostic factors. There were 258 patients [median age was 37 (18-75) years; [males:160 (62%); stage I: 41%; B symptoms: 17 (6%); bulky disease:19 (15%)] treated between 2000 and 2020 who were evaluable. The common chemotherapies used were ABVD [N = 180 (70%)], COPP-ABVD hybrid [N = 52 (21%)], and COPP [N = 14 (5%)]. Median number of cycles were 4 (2-8) and 93 (47%) received radiation at end of treatment. After a median follow-up of 60 months, the 5 years EFS was 87% and OS was 92%. On multivariate analysis, the following factors adversely affected the EFS: Male gender [hazard ratio (HR) = 2.23, P = 0.02] and Hemoglobin < 10.5g/dL [hazard ration (HR) = 2.20, P = 0.02], and the following adversely affected the OS: Hemoglobin < 10.5g/dL [hazard ratio (HR) = 4.05, P = 0.001], Male gender [hazard ratio (HR) = 3.59, P = 0.004], Stage 2 [hazard ratio (HR) = 2.65, P = 0.002] and ECOG PS (2-3) [hazard ratio (HR) = 3.35, P = 0.01]. Using the hemoglobin, stage and gender a 3-item prognostic score could identify patients with very good outcomes (score 0; 5 years OS:100%) and poor outcomes (score 3; 5 years OS; 49%). This is one of the first multi-center real-world data exclusively focusing on ESHL from India. Though the survival of the entire population was good, there are subsets of patients who have poor outcomes, which may be identified using simple parameters. These parameters need validation in a larger dataset. Supplementary Information The online version contains supplementary material available at 10.1007/s12288-023-01692-9.
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Affiliation(s)
- Lakshmi Sandhya Singuluri
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), 3rd Floor, SSB, Dhanvantari Nagar, Puducherry, 605006 India
| | | | - Luxitaa Goenka
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), 3rd Floor, SSB, Dhanvantari Nagar, Puducherry, 605006 India
| | - Praveen Kumar Shenoy
- Department of Clinical Hematology and Medical Oncology, Malabar Cancer Center, Thalassery, India
| | - Krishna Kumar Rathnam
- Department of Medical Oncology, Madurai Meenakshi Mission Hospital and Research Center, Madurai, India
| | | | - Nikita Mehra
- Department of Medical Oncology, Cancer Institute (WIA), Chennai, India
| | | | | | - Vineetha Raghavan
- Department of Clinical Hematology and Medical Oncology, Malabar Cancer Center, Thalassery, India
| | - Chandran K. Nair
- Department of Clinical Hematology and Medical Oncology, Malabar Cancer Center, Thalassery, India
| | - Biswajit Dubashi
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), 3rd Floor, SSB, Dhanvantari Nagar, Puducherry, 605006 India
| | | | - Prasanth Ganesan
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), 3rd Floor, SSB, Dhanvantari Nagar, Puducherry, 605006 India
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Ionică M, Biris M, Gorun F, Nicolae N, Popa ZL, Muresan MC, Forga M, Erdelean D, Erdelean I, Gorun MA, Neagoe OC. Predictive Role of Pre-Operative Anemia in Early Recurrence of Endometrial Cancer: A Single-Center Study in Romania. J Clin Med 2024; 13:794. [PMID: 38337488 PMCID: PMC10856108 DOI: 10.3390/jcm13030794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/16/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
This study aims to investigate the association between anemia and early recurrence in endometrial cancer patients. We retrospectively analyzed the data of 473 endometrial cancer patients treated at our hospital from January 2015 to December 2020. Patients were divided into two groups based on their hemoglobin (Hb) level: anemia group (Hb < 12 g/dL) and non-anemia group (Hb ≥12 g/dL). Early recurrence was defined as recurrence within 2 years of diagnosis. Univariate and multivariate logistic regression analyses were used to identify the predictors of early recurrence. The prevalence of anemia was 38.26% (181/473). The incidence of early recurrence was 12.89% (61/473) in the anemia group and 9.24% (38/412) in the non-anemia group (p = 0.004). Univariate analysis showed that anemia was a significant predictor of early recurrence (odds ratio (OR) = 2.27, 95% confidence interval (CI): 1.35-3.80, p = 0.003). Multivariate analysis confirmed that anemia was an independent predictor of early recurrence (OR = 2.11, 95% CI: 1.21-3.84, p = 0.01). Anemia is an independent predictor of early recurrence in endometrial cancer patients. Patients with endometrial cancer should be screened for anemia and treated if present. Additionally, patients with anemia should be closely monitored for early signs of recurrence and treated aggressively.
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Affiliation(s)
- Mihaela Ionică
- Second Clinic of General Surgery and Surgical Oncology, Emergency Clinical Municipal Hospital, 300079 Timisoara, Romania; (M.I.); (O.C.N.)
- Second Discipline of Surgical Semiology, First Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marius Biris
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (N.N.); (Z.L.P.); (M.C.M.); (M.F.); (D.E.); (I.E.)
| | - Florin Gorun
- Department of Obstetrics and Gynecology, Municipal Emergency Clinical Hospital Timisoara, 300172 Timisoara, Romania;
| | - Nicoleta Nicolae
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (N.N.); (Z.L.P.); (M.C.M.); (M.F.); (D.E.); (I.E.)
| | - Zoran Laurentiu Popa
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (N.N.); (Z.L.P.); (M.C.M.); (M.F.); (D.E.); (I.E.)
| | - Maria Cezara Muresan
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (N.N.); (Z.L.P.); (M.C.M.); (M.F.); (D.E.); (I.E.)
| | - Marius Forga
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (N.N.); (Z.L.P.); (M.C.M.); (M.F.); (D.E.); (I.E.)
| | - Dragos Erdelean
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (N.N.); (Z.L.P.); (M.C.M.); (M.F.); (D.E.); (I.E.)
| | - Izabella Erdelean
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (N.N.); (Z.L.P.); (M.C.M.); (M.F.); (D.E.); (I.E.)
| | | | - Octavian Constantin Neagoe
- Second Clinic of General Surgery and Surgical Oncology, Emergency Clinical Municipal Hospital, 300079 Timisoara, Romania; (M.I.); (O.C.N.)
- Second Discipline of Surgical Semiology, First Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Naryzhny S, Ronzhina N, Zorina E, Kabachenko F, Klopov N, Zgoda V. Construction of 2DE Patterns of Plasma Proteins: Aspect of Potential Tumor Markers. Int J Mol Sci 2022; 23:ijms231911113. [PMID: 36232415 PMCID: PMC9569744 DOI: 10.3390/ijms231911113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/16/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
The use of tumor markers aids in the early detection of cancer recurrence and prognosis. There is a hope that they might also be useful in screening tests for the early detection of cancer. Here, the question of finding ideal tumor markers, which should be sensitive, specific, and reliable, is an acute issue. Human plasma is one of the most popular samples as it is commonly collected in the clinic and provides noninvasive, rapid analysis for any type of disease including cancer. Many efforts have been applied in searching for “ideal” tumor markers, digging very deep into plasma proteomes. The situation in this area can be improved in two ways—by attempting to find an ideal single tumor marker or by generating panels of different markers. In both cases, proteomics certainly plays a major role. There is a line of evidence that the most abundant, so-called “classical plasma proteins”, may be used to generate a tumor biomarker profile. To be comprehensive these profiles should have information not only about protein levels but also proteoform distribution for each protein. Initially, the profile of these proteins in norm should be generated. In our work, we collected bibliographic information about the connection of cancers with levels of “classical plasma proteins”. Additionally, we presented the proteoform profiles (2DE patterns) of these proteins in norm generated by two-dimensional electrophoresis with mass spectrometry and immunodetection. As a next step, similar profiles representing protein perturbations in plasma produced in the case of different cancers will be generated. Additionally, based on this information, different test systems can be developed.
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Affiliation(s)
- Stanislav Naryzhny
- Institute of Biomedical Chemistry, Pogodinskaya, 10, 119121 Moscow, Russia
- Petersburg Institute of Nuclear Physics (PNPI) of National Research Center “Kurchatov Institute”, 188300 Gatchina, Russia
- Correspondence: ; Tel.: +7-911-176-4453
| | - Natalia Ronzhina
- Petersburg Institute of Nuclear Physics (PNPI) of National Research Center “Kurchatov Institute”, 188300 Gatchina, Russia
| | - Elena Zorina
- Institute of Biomedical Chemistry, Pogodinskaya, 10, 119121 Moscow, Russia
| | - Fedor Kabachenko
- Institute of Biomedical Systems and Biotechnology, Peter the Great St. Petersburg Polytechnic University, 195251 St. Petersburg, Russia
| | - Nikolay Klopov
- Petersburg Institute of Nuclear Physics (PNPI) of National Research Center “Kurchatov Institute”, 188300 Gatchina, Russia
| | - Victor Zgoda
- Institute of Biomedical Chemistry, Pogodinskaya, 10, 119121 Moscow, Russia
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Merriel SWD, Ingle SM, May MT, Martin RM. Retrospective cohort study evaluating clinical, biochemical and pharmacological prognostic factors for prostate cancer progression using primary care data. BMJ Open 2021; 11:e044420. [PMID: 33579772 PMCID: PMC7883851 DOI: 10.1136/bmjopen-2020-044420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To confirm the association of previously reported prognostic factors with future progression of localised prostate cancer using primary care data and identify new potential prognostic factors for further assessment in prognostic model development and validation. DESIGN Retrospective cohort study, employing Cox proportional hazards regression controlling for age, prostate specific antigen (PSA), and Gleason score, was stratified by diagnostic stage. SETTING Primary care in England. PARTICIPANTS Males with localised prostate cancer diagnosedbetween 01/01/1987 and 31/12/2016 within the Clinical Practice ResearchDatalink database, with linked data from the National Cancer Registration andAnalysis Service and Office for National Statistics. PRIMARY AND SECONDARY OUTCOMES Primary outcome measure was prostate cancer mortality. Secondary outcome measures were all-cause mortality and commencing systemic therapy. Up-staging after diagnosis was not used as a secondary outcome owing to significant missing data. RESULTS 10 901 men (mean age 74.38±9.03 years) with localised prostate cancer were followed up for a mean of 14.12 (±6.36) years. 2331 (21.38%) men underwent systemic therapy and 3450 (31.65%) died, including 1250 (11.47%) from prostate cancer. Factors associated with an increased risk of prostate cancer mortality included age; high PSA; current or ex-smoker; ischaemic heart disease; high C reactive protein; high ferritin; low haemoglobin; high blood glucose and low albumin. CONCLUSIONS This study identified several new potential prognostic factors for prostate cancer progression, as well as confirming some known prognostic factors, in an independent primary care data set. Further research is needed to develop and validate a prognostic model for prostate cancer progression.
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Affiliation(s)
| | - Suzanne Marie Ingle
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Margaret T May
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Richard M Martin
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
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Hastuti AAMB, Costas-Rodríguez M, Matsunaga A, Ichinose T, Hagiwara S, Shimura M, Vanhaecke F. Cu and Zn isotope ratio variations in plasma for survival prediction in hematological malignancy cases. Sci Rep 2020; 10:16389. [PMID: 33009454 PMCID: PMC7532200 DOI: 10.1038/s41598-020-71764-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 07/23/2020] [Indexed: 12/31/2022] Open
Abstract
We have examined potential changes in the isotopic compositions of Fe, Cu and Zn (using multi-collector inductively coupled plasma-mass spectrometry) and the corresponding concentrations (using inductively coupled plasma-atomic emission spectrometry) in plasma from hematological malignancy (HM) patients and assessed their prognostic capability. Together with clinical laboratory test values, data were examined in view of a 5-years survival prediction. Plasma Cu and Zn isotope ratios and their concentrations were significantly different in HM patients compared to matched controls (P < 0.05). Both δ65Cu and δ66Zn values showed significant mortality hazard ratios (HRs) in HM. The group of patients with decreased δ65Cu and increased δ66Zn values showed significantly poorer survival from the early phase (HR 3.9; P = 0.001), forming a unique cohort not identified based on laboratory test values. Well-known prognostic factors for HM, such as the creatinine level, and anemia-related values were highly correlated with the δ66Zn value (P < 0.05). Time-dependent ROC curves based on the δ65Cu or δ66Zn value were similar to that based on the creatinine concentration (a well-known prognostic factor in HM), indicating that δ65Cu or δ66Zn values are useful for prognosis of HM. Variations in stable isotope ratios of essential mineral elements have thus been shown to reflect alterations in their homeostasis due to physiological changes in malignancies with higher sensitivity than concentrations do.
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Affiliation(s)
- Agustina A M B Hastuti
- Department of Chemistry, Atomic & Mass Spectrometry - A&MS Research Unit, Ghent University, Campus Sterre, Krijgslaan 281 - S12, 9000, Ghent, Belgium
| | - Marta Costas-Rodríguez
- Department of Chemistry, Atomic & Mass Spectrometry - A&MS Research Unit, Ghent University, Campus Sterre, Krijgslaan 281 - S12, 9000, Ghent, Belgium
| | - Akihiro Matsunaga
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan
| | - Takayuki Ichinose
- Inorganic Analysis Laboratories, Toray Research Center, Inc., Otsu, Shiga, 520-8567, Japan
| | - Shotaro Hagiwara
- Division of Hematology, Internal Medicine, Hospital, National Center for Global Health and Medicine, Shinjuku, Tokyo, Japan.,Department of Hematology, Tokyo Women's Medical University, Shinjuku, Tokyo, 162-8666, Japan
| | - Mari Shimura
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan.
| | - Frank Vanhaecke
- Department of Chemistry, Atomic & Mass Spectrometry - A&MS Research Unit, Ghent University, Campus Sterre, Krijgslaan 281 - S12, 9000, Ghent, Belgium.
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Limbach M, Kuehl R, Dreger P, Luft T, Rosenberger F, Kleindienst N, Friedmann-Bette B, Bondong A, Bohus M, Wiskemann J. Influencing factors of cardiorespiratory fitness in allogeneic stem cell transplant candidates prior to transplantation. Support Care Cancer 2020; 29:359-367. [PMID: 32367227 PMCID: PMC7686174 DOI: 10.1007/s00520-020-05485-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/20/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE Cardiorespiratory fitness (CRF) seems to be prognostic prior to allogeneic stem cell transplantation (allo-HSCT). Influencing factors of CRF in allo-HSCT candidates have not been studied so far. Aim was to identify potentially influencing factors on CRF. METHODS To assess CRF, a maximal cardiopulmonary exercise test (CPET) was performed on average 2.6 ± 7.2 days prior to admission. A regression analysis was conducted, with the following predictors: gender, age, body mass index (BMI), time between last therapy and allo-HSCT (t_Therapies), number of cardiotoxic therapies (n_Cardiotox), number of transplantations (n_Transplantations), comorbidity index (HCT-CI), hemoglobin level of the last 3 months (area under the curve), and physical activity. RESULTS A total of 194 patients performed a CPET. VO2peak was significantly reduced compared with reference data. In total, VO2peak was 21.4 ml/min/kg (- 27.5%, p < 0.05). Men showed a significant larger percentage difference from reference value (- 29.1%, p < 0.05) than women (- 24.4%). VO2peak was significantly (p < 0.05) influenced by age (β = - 0.11), female gender (β = - 3.01), BMI (β = - 0.44), n_Cardiotox (β = - 0.73), hemoglobin level (β = 0.56), and physical activity prior to diagnosis (β = 0.10). CONCLUSIONS Our study demonstrates a decreased CRF indicating the potential need of prehabilitative exercise. We revealed some influencing factors on CRF. Those patients could benefit the most from exercise.
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Affiliation(s)
- Matthias Limbach
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Rea Kuehl
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Peter Dreger
- Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Luft
- Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Friederike Rosenberger
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | | | - Birgit Friedmann-Bette
- Internal Medicine VII (Sports Medicine), Heidelberg University Hospital, Heidelberg, Germany
| | - Andrea Bondong
- Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Bohus
- Central Institute of Mental Health, Mannheim, Germany
| | - Joachim Wiskemann
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.
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Pathak RS, Pantarotto JR, Cook G, Holmes O, Cross P, MacRae RM. Anemia is a poor prognostic factor for stage I non-small cell lung cancer (NSCLC) patients treated with Stereotactic Body Radiation Therapy (SBRT). Clin Transl Radiat Oncol 2019; 16:28-33. [PMID: 30923751 PMCID: PMC6423348 DOI: 10.1016/j.ctro.2019.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/09/2019] [Indexed: 12/16/2022] Open
Abstract
•This study reports on the prognostic ability of haematological parameters for the largest known biopsy-proven stage-I medically inoperable cohort treated with SBRT.•After SBRT, the median values of Hb, ALC, ANC and TPC declined whereas the NLR and the PLR increased as compared to pre-SBRT.•Anemia along with other parameters was found to be a poor prognostic factor for local control despite treatment with SBRT to doses of >100 Gy BED10.•Simple and minimally invasive methods like a peripheral blood sample can provide prognostic information even for stage-I NSCLC patients.•Patient, tumor and treatment factors along with molecular markers should be used to create risk stratification models that can guide therapy.
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Affiliation(s)
- Rima S. Pathak
- Division of Radiation Oncology, The University of Ottawa, Ottawa, ON, The Ottawa Hospital Cancer Centre, Canada
| | - Jason R. Pantarotto
- Division of Radiation Oncology, The University of Ottawa, Ottawa, ON, The Ottawa Hospital Cancer Centre, Canada
| | - Graham Cook
- Division of Radiation Oncology, The University of Ottawa, Ottawa, ON, The Ottawa Hospital Cancer Centre, Canada
| | - Oliver Holmes
- Discipline of Oncology, Dr. H. Bliss Murphy Cancer Centre, St. John’s, Newfoundland and Labrador, Canada
| | - Peter Cross
- Division of Radiation Oncology, The University of Ottawa, Ottawa, ON, The Ottawa Hospital Cancer Centre, Canada
| | - Robert M. MacRae
- Division of Radiation Oncology, The University of Ottawa, Ottawa, ON, The Ottawa Hospital Cancer Centre, Canada
- Corresponding author at: Box 903, The Ottawa Hospital, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada.
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Hoogsteen IJ, Pop LAM, Marres HAM, Merkx MAW, van den Hoogen FJA, van der Kogel AJ, Kaanders JHAM. Oxygen-modifying treatment with ARCON reduces the prognostic significance of hemoglobin in squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys 2005; 64:83-9. [PMID: 16213107 DOI: 10.1016/j.ijrobp.2005.07.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2005] [Revised: 06/22/2005] [Accepted: 06/25/2005] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the prognostic significance of hemoglobin (Hb) levels measured before and during treatment with accelerated radiotherapy with carbogen and nicotinamide (ARCON). METHODS AND MATERIALS Two hundred fifteen patients with locally advanced tumors of the head and neck were included in a phase II trial of ARCON. This treatment regimen combines accelerated radiotherapy for reduction of repopulation with carbogen breathing and nicotinamide to reduce hypoxia. In these patients, Hb levels were measured before, during, and after radiotherapy. RESULTS Preirradiation and postirradiation Hb levels were available for 206 and 195 patients respectively. Hb levels below normal were most frequently seen among patients with T4 (p < 0.001) and N2 (p < 0.01) disease. Patients with a larynx tumor had significantly higher Hb levels (p < 0.01) than other tumor sites. During radiotherapy, 69 patients experienced a decrease in Hb level. In a multivariate analysis there was no prognostic impact of Hb level on locoregional control, disease-free survival, and overall survival. Primary tumor site was independently prognostic for locoregional control (p = 0.018), and gender was the only prognostic factor for disease-free and overall survival (p < 0.05). High locoregional control rates were obtained for tumors of the larynx (77%) and oropharynx (72%). CONCLUSION Hemoglobin level was not found to be of prognostic significance for outcome in patients with squamous cell carcinoma of the head and neck after oxygen-modifying treatment with ARCON.
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Affiliation(s)
- Ilse J Hoogsteen
- Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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