Abstract
Anemia is a well-recognized complication of concurrent chemoradiation therapy for head and neck carcinoma. It impairs quality of life and many studies also have reported an association between anemia and increased tumor recurrence and decreased long-term survival. In the current study, the authors attempted to identify the severity, risk factors, and physician practices in the management of anemia. Medical records of those patients receiving concurrent chemoradiation for head and neck carcinoma between 1999-2003 were reviewed. The average weekly nadir hemoglobin level (AWNH) was defined as the mean value of the lowest hemoglobin concentration in each week. Independent predictors for an AWNH < 11 g/dL were identified using multivariable logistic regression analyses. Seventy-two patients were included in the current study, 66.7% of whom had unresectable disease. The overall median survival was 402 days. At baseline, 76.4% (95% confidence interval [95% CI], 66.3-86.4%) of patients already had a hemoglobin level < 13.5 g/dL. The hemoglobin level dropped 2.5 +/- 1.9 g/dL during concurrent chemoradiation, resulting in 95.8% of patients having a hemoglobin level < 13.5 g/dL at the end of the observation period. Blood was transfused to...Continue Reading
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