Influencing factors and prognostic values of hemoglobin changes in prostate cancer patient during radiotherapy combined with androgen-deprivation therapy / 中华放射肿瘤学杂志

ABSTRACT

Objective:To analyze the influencing factors of hemoglobin changes in prostate cancer patients during radiotherapy combined with androgen-deprivation therapy (ADT) and analyze the relationship between the hemoglobin changes and long-term prognosis.Methods:The changes of hemoglobin levels in 145 prostate cancer patients treated with radiotherapy combined with ADT in Department of Radiation Oncology of Peking University First Hospital from November 2011 to May 2015 were retrospectively analyzed. Intensity-modulated radiotherapy (IMRT) was employed for conventionally fractionated radiotherapy. Luteinizing hormone-releasing hormone agonist was utilized for endocrine therapy.Results:The median hemoglobin reduction during radiotherapy combined with ADT was 8 g/L. The higher the baseline level of hemoglobin, pelvic irradiation and GS score before radiotherapy, the more obvious the decrease of hemoglobin during treatment (all P<0.001). Pelvic radiotherapy significantly increased the decline tendency of hemoglobin throughout the combined treatment (86.8% vs. 72.8%, P=0.05). The duration of endocrine therapy before radiotherapy and the hemoglobin changes during endocrine therapy alone were not significantly correlated with the degree of hemoglobin decline during subsequent radiotherapy ( P=0.53 and 0.837). The biochemical failure-free survival did not significantly differ between patients with significant and mild hemoglobin reduction ( P=0.686). Conclusions:The baseline level of hemoglobin before radiotherapy is negatively correlated with the decrease of hemoglobin during combined therapy. Pelvic radiotherapy is positively correlated with hemoglobin reduction during combined therapy. Hemoglobin reduction during combined therapy is not associated with the long-term biochemical failure-free survival of patients.