Impact of Hemoglobin (Hgb) Level and Use of Recombinant Human Erythropoieten (r-HuEPO) on Response to Neoadjuvant Chemoradiation Therapy, Tumor Control, and Survival in Patients With Oral or Oropharyngeal Squamous Cell Carcinoma (SCCA)

James Metz, MD
OncoLink Associate Editor
Last Modified: November 1, 1999

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Presenter: Christoph M. Glaser, MD
Affiliation: General Hospital Vienna, Austria

Anemia is a frequent finding in patients with head and neck cancer and has been found to be a poor prognostic factor. This study was performed to evaluate the impact of r-HuEPO on patients with a low Hgb level.

All 187 patients in this retrospective study received neoadjuvant chemoradiation therapy prior to surgical resection of their head and neck cancer. Patients were divided into 3 groups: Group 1 had a Hgb > 14.5 g/dl and received no r-HuEPO (1990-1998), Group 2 (1990-1996) and Group 3 (1996-1998) had Hgb <14.5 g/dl but only Group 3 was treated with r-HuEPO.


  • The pathologic complete response was 65% in Group 1, 17% in Group 2, and 61% in Group 3.
  • Actuarial overall survival was 84% in Group 1, 62% in Group 2 and 93% in Group 3.

Clinical/Scientific Implications:

  • These preliminary data suggest that correction of low Hgb levels with r-HuEPO may improve local tumor control and overall survival in head and neck cancer patients.
  • The follow-up time for the group of patients treated with r-HuEPO is relatively short requiring longer term evaluation of these patients.
  • Studies evaluating r-HuEPO in patients with low Hgb who will receive definitive chemoradiation therapy for head and neck cancer should be considered.

ASTRO coverage is sponsored, in part, by Varian Medical Systems, Inc.

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