• Strahlenther Onkol · Sep 2003

    Comparative Study

    Prognostic impact of hemoglobin level prior to radiotherapy on survival in patients with glioblastoma.

    • Karel Odrazka, Jiri Petera, Tereza Kohlova, Martin Dolezel, Miloslava Vaculikova, Milan Zouhar, Vaclav Malek, Vladimir Hobza, Ivan Latr, Stanislav Nemecek, Miroslav Sercl, Pavel Ryska, Milan Blaha, and Eva Cermakova.
    • Department of Oncology and Radiotherapy, Charles University Hospital, Hradec Kralove, Czech Republic. odrazka@fnhk.cz
    • Strahlenther Onkol. 2003 Sep 1; 179 (9): 615-9.

    PurposeTo evaluate prognostic factors in patients with glioblastoma treated with postoperative or primary radiotherapy.Patients And MethodsFrom 1989 to 2000, a total of 100 patients underwent irradiation as part of their initial treatment for glioblastoma. All patients had undergone surgery or biopsy followed by conventional external-beam radiotherapy. 85 patients who received the planned dose of irradiation (60 Gy in 30 fractions) were analyzed for the influence of prognostic factors. 73/85 (86%) of patients were given postoperative irradiation, while 12/85 (14%) of patients were primarily treated with radiotherapy after biopsy.ResultsThe median overall survival was 10.1 months (range, 3.7-49.8 months), the 1- and 2-year survival rates were 41% and 5%, respectively. Univariate analysis revealed age < or = 55 years (p < 0.001), pre-radiotherapy hemoglobin (Hb) level > 12 g/dl (p = 0.009), and pre-radiotherapy dose of dexamethasone < or = 2 mg/day (p = 0.005) to be associated with prolonged survival. At multivariate analysis, younger age (p < 0.001), higher Hb level (p = 0.002), lower dose of dexamethasone (p = 0.026), and a hemispheric tumor location (p = 0.019) were identified as independent prognostic factors for longer survival. The median survival for patients with an Hb level > 12 g/dl was 12.1 months compared to 7.9 months for those with a lower Hb level. Contingency-table statistics showed no significant differences for the two Hb groups in the distribution of other prognostic factors.ConclusionThe results indicate that lower Hb level prior to radiotherapy for glioblastoma can adversely influence prognosis. This finding deserves further evaluation.

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