||Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2012, vol. 18, book 1
Subject Collection: Medicine
Page: 209 - 212
Published online: 07 February 2012
J of IMAB 2012; 18(1):209-212
The Hemoglobin Level as a Prognostic Factor in Patients with Non-Small Cell Lung Cancer Treated with Gemcitabine and cis-Platinum
Deyan N. Davidov
Department of Chemotherapy, UMHAT "Dr. G. Stranski", MedicalUniversity, Pleven, Bulgaria.
Objective: Anemia is observed in various malignancies including non- small cell lung cancer /NSCLC/ and is considered to be a poor prognostic factor. The aim of this study is to investigate whether there is a correlation between anemia, other clinic- pathological factors and survival in patients with advanced NSCLC treated with Gemcitabine / cis- Platinum- containing chemotherapy.
Methods: Seventy eight consecutive patients with advanced NSCLC treated in Department of Chemotherapy, UMHAT - Dr. G. Stranski, Medical University - Pleven between 2006-2008 were retrospectively analyzed. Of those, 27 patients /34, 6%/ had low hemoglobin /HB/ level (<120g/L for men and <110g/L for women) prior to start chemotherapy. The HB levels were obtained at the time of their first visit to the hospital. All patients received chemotherapy regimen consists of intravenous administration of Gemcitabine 1250 mg/m2 day 1 and 8 and cis- Platinum 80mg/m2 day 1 with repetition over 21 days. Survival analysis was evaluated by Kaplan- Meier test.
Results: The median survival time for all patients was 9,5 months. The median survival time for patients with low HB levels was 7,6 months versus 11,3 months in patients without anemia /p<0.05/. There was a significant correlation between anemia and clinical stage or performance status /p<0.05/.
Conclusions: These results indicate that patients without anemia have significantly higher survival rate. Pretreatment HB level appears to be a useful prognostic indicator for survival in patients with inoperable NSCLC treated with chemotherapy.
Key words: Hemoglobin, Prognostic factors, Non small cell lung cancer, Chemotherapy, Survival.
- Download FULL TEXT ( PDF 140 KB )
Please cite this article as: Davidov DN. The Hemoglobin Level as a Prognostic Factor in Patients with Non-Small Cell Lung Cancer Treated with Gemcitabine and cis-Platinum. J of IMAB. 2012; 18(1):209-212. doi: 10.5272/jimab.2012181.209
1. Jemal A., R. Siegel, E. Ward, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009, CA: Cancer J Clinicians, 2009 Jul-Aug;59(4):225-49. Epub 2009 May 27. [CrossRef] [PubMed]
2. Rapp E, Pater JL, Willan A, Cormier Y, Murray N, Evans WK, et al. Chemotherapy can prolong survival in patients with advanced non-small-cell lung cancer- report of a Canadian multicenter randomized trial. J Clin Oncol. 1988 Apr;6(4):633-641. [PubMed]
3. Bunn PA Jr, Kelly K. New chemotherapeutic agents prolong survival and improve quality of life in non small cell lung cancer: a review of the literature and future directions, Clin Cancer Res, 1998 May; 4(5):1087- 1100. [PubMed]
4. Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J, et al, Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer, N Eng J Med. 2002 Jan;346(2):92-98, [CrossRef][PubMed]
5. O’Connell J., Kris M., Gralla R., Groshen S, Trust A, Fiore JJ, et al, Frequency and prognostic importance of pretreatment clinical characteristics in patients with advanced non-small- cell lung cancer treated with combination chemotherapy, J Clin Oncol, 1986 Nov;4(11):1604- 17. [PubMed]
6. Tesarova P, Kvasnicka J. [Treatment of anemia in patients with tumors]. Cas Leuk Ces 1995 Oct 18;134(20):647- 50. [Article in Czech] [PubMed]
7. De Rienzo DP, Saleem A. Anaemia of chronic disease: a review of pathogenesis. Texas Med 1990 Oct;86(10):80-3. [PubMed]
8. Ludwig H, Fritz E. Anemia in cancer patients. Semin Oncol 1998 Jun;25(3 Suppl 7):2-6. [PubMed]
9. Glaspy J, Bukowski R, Steinberg D, Taylor C, Tchekmedyian S, Vadhan-Raj S. Impact of therapy with epoetin alpha on clinical outcomes in patients with nonmyeloid malignancies during cancer chemotherapy in community oncology practice. J Clin Oncol. 1997 Mar;15(3):1218 –34. [PubMed]
10. Miller AB, Hoogstraten B, Staquet M, Winkler A. Reporting results of cancer treatment. Cancer. 1981 Jan 1;47(1):207-214. [PubMed]
11. Brimdage MD, Pater JL, Zee B. Assessing the reliability of two toxicity scales: Implications for interpreting toxicity data. J Natl Cancer Inst.1993 Jul 21;85(14)1138-48. [CrossRef] [PubMed]
12. Kaplan EL, Meier P, Non-parametric estimation from incomplete observations. J Am Stat Assoc. 1959; 53; 457-481
13. Crino L, Tonato M, Darwis S, Meacci ML, Corgna E, Di Costanzo F, et al. A randomized trial of 3 cisplatin containing regimens in NSCLC. A study of the Umbrian Lung Cancer Group, Cancer Chemother Pharmacol. 1990 26(1):52-56. [PubMed]
14. Weick J, Crowley J, Natale RB, Hom BL, Rivkin S, Coltman CA Jr, et al. A randomized trial of five cisplatin- containing treatments in patients with metastatic non- small- cell lung cancer: A Southwest Oncology group study. J Clin Oncol. 1991 Jul; 9(7):1157- 1162. [PubMed]
15. Knight K, Wade S, Balducci L. Prevalence and outcomes of anemia in cancer: a systemic review of the literature, Am J Med. 2004 Apr 5;116 Suppl 7A 11S-16S. [CrossRef] [PubMed]
16. Caro J., Salas M., Ward A. Goss G. Anemia as independent prognostic factor for survival in patients with cancer. A systemic, quantitative review, Cancer. 2001 Jun 15;91(12):2214- 2221. [PubMed].
Accepted for publication: 28 August 2011
Issue published online: 07 February 2012
back to Online Journal