Publication:
Chemoradiotherapy-induced hemoglobin nadir values and survival in patients with stage III non-small cell lung cancer

dc.contributor.coauthorTopkan, Erkan
dc.contributor.coauthorÖzdemir, Yurday
dc.contributor.coauthorYıldırım, Berna A.
dc.contributor.coauthorGüler, Ozan C.
dc.contributor.coauthorMertsoylu, Hüseyin
dc.contributor.coauthorHahn, Stephen M.
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorSelek, Uğur
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2024-11-09T23:29:37Z
dc.date.issued2018
dc.description.abstractPurpose: We investigated the influence of change in hemoglobin (Hgb) levels during concurrent chemoradiotherapy (C-CRT) on outcomes of non-anemic patients with stage IIIA/B non-small cell lung cancer (NSCLC). Methods: We identified 722 patients with stage IIIA/B NSCLC without anemia at baseline [hemoglobin (Hgb) < 12 g/dL for women or < 13 g/dL for men], either nonsmokers or ex-smokers, who received C-CRT between 2007 and 2012. All patients had received 1 - 3 cycles of platinum-based doublet chemotherapy during radiotherapy to 60 - 66 Gy and had documented Hgb measurements before treatment and at weekly intervals for 6 weeks during the C-CRT. Potential associations were assessed between baseline, nadir, extent of change in Hgb level, and anemia and overall survival (OS), locoregional progression-free survival (LRPFS), and PFS. Results: The median baseline Hgb level was 13.9 g/dL (range 12.0-16.8) and declined to a median 12.4 g/dL (range 7.9-16.1) during treatment. Anemia appeared in 237 patients (32.8%) and was more common among women (44.8% vs. 26.5%, P < 0.001). Neither baseline Hgb level nor change during treatment nor anemia emergence influenced any survival endpoint. Receiver operating curve analysis revealed an Hgb nadir of 11.1 g/dL to be associated with outcomes, in that a nadir Hgb < 11.1 g/dL (in 156 patients) was linked with shorter median OS time (P < 0.001), LRPFS time (P < 0.001), and PFS time (P < 0.001); retained significance for all three endpoints in multivariate analyses; and was more strongly associated with OS in squamous cell carcinoma (P < 0.001) than in adenocarcinoma (P = 0.009). Conclusion: Nadir Hgb < 11.1 g/dL levels during C-CRT were associated with significantly poorer survival times in initially non-anemic patients presenting with locally advanced NSCLC.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.openaccessNO
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume121
dc.identifier.doi10.1016/j.lungcan.2018.04.016
dc.identifier.eissn1872-8332
dc.identifier.issn0169-5002
dc.identifier.quartileQ2
dc.identifier.scopus2-s2.0-85046090795
dc.identifier.urihttps://doi.org/10.1016/j.lungcan.2018.04.016
dc.identifier.urihttps://hdl.handle.net/20.500.14288/12077
dc.identifier.wos436222300006
dc.keywordsAnemia
dc.keywordsChemoradiotherapy
dc.keywordsNadir hemoglobin
dc.keywordsStage Iiia/B non-small cell lung cancer
dc.keywordsPrognostic-factor
dc.keywordsAnemia
dc.keywordsRadiotherapy
dc.keywordsCarcinoma
dc.keywordsErythropoietin
dc.keywordsChemoradiation
dc.keywordsTherapy
dc.language.isoeng
dc.publisherElsevier Ireland Ltd
dc.relation.ispartofLung Cancer
dc.subjectOncology
dc.subjectRespiratory organs
dc.subjectRespiration
dc.titleChemoradiotherapy-induced hemoglobin nadir values and survival in patients with stage III non-small cell lung cancer
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorSelek, Uğur
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit2School of Medicine
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relation.isOrgUnitOfPublication.latestForDiscoveryd02929e1-2a70-44f0-ae17-7819f587bedd
relation.isParentOrgUnitOfPublication17f2dc8e-6e54-4fa8-b5e0-d6415123a93e
relation.isParentOrgUnitOfPublication.latestForDiscovery17f2dc8e-6e54-4fa8-b5e0-d6415123a93e

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