n South African Journal of Obstetrics and Gynaecology - Haemoglobin level as the prognostic factor for patients with carcinoma of the cervix receiving radiation therapy : research article




The primary objective was to assess the influence of the pre-treatment and mid-treatment haemoglobin (Hb) level on local control and pelvic disease-free and overall disease-free survival in patients with carcinoma of the cervix receiving radiation therapy.

Seventy-two patients referred for radiation therapy for carcinoma of the cervix between January and December 2002 were entered into this prospective study. Forty-three patients (60%) had stage II and 29 (40%) 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 12.8 g / dl and 12.1 g / dl, respectively.
Treatment failed in 13 patients (pelvic disease 9, distant 3 and pelvic and distant 1). Patients with mid-treatment Hb levels ≥ 12 g / dl had significantly lower rates of pelvic failure ( = 0.05) as well as overall failure ( = 0.03) than patients with levels < 12 g / dl. The patients with mid-treatment Hb levels ≥ 12 g / dl had 5-year pelvic disease-free survival and overall disease-free survival rates of 83% and 81%, as opposed to 66% and 58% for patients with Hb levels < 12 g / dl ( = 0.04 and = 0.02). The 5-year pelvic disease-free survival rate for stage II disease was 89% compared with 45% for stage III ( = 0.006).
A mid-treatment Hb level of ≥ 12 g / dl was associated with significantly improved control of pelvic disease and improved 5-year pelvic disease-free and overall survival. Disease stage was an independent prognostic factor.


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