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

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.

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