The impact of anemia on outcome of chemoradiation for limited small-cell lung cancer: A combined analysis of studies of the National Cancer Institute of Canada Clinical Trials Group

Abstract

Background: Associations between anemia and outcomes of chemoradiation have been documented in several malignancies, but few data exist for limited small-cell lung cancer (LD-SCLC). This combined analysis of 652 patients in two randomized clinical trials in LD-SCLC carried out by the National Cancer Institute of Canada Clinical Trials Group was undertaken to explore the relationship between anemia at baseline and anemia arising during therapy, and outcomes of chemoradiation in this cancer. Patients and methods: The relationships between overall survival and local control with hemoglobin levels at baseline and those arising during therapy (nadir hemoglobin (Hb) and maximum percentage drop from baseline values) were explored. Results: No Hb parameter was associated with either outcome. Baseline anemia was found in one-third of patients, was more common in males, in those with a poorer performance status and those with an elevated lactate dehydrogenase; all of these latter factors were associated with shorter survival. A trend towards improved local control in patients with the greatest drop in their Hb did not remain significant in a multivariate analysis. Conclusions: Anemia is common in patients with LD-SCLC. Anemia at diagnosis may have a different prognostic implication than that arising during therapy, and correction of anemia may have no impact on outcomes. © 2007 European Society for Medical Oncology.