The effects of hemoglobin levels and their interactions with cigarette smoking on survival in nasopharyngeal carcinoma patients

Zeng, Qi; Shen, Lu; Li, Sheng; Chen, Ling; Guo, Xiang; Qian, Chao Nan; Wu, Pei Hong

doi:10.1002/cam4.647

Cited by 10 publications

(10 citation statements)

References 40 publications

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“…anemia is either present at the pre-treatment period or emerges de novo during the treatment course) and searched for a particular cut-off Hgb value that may be useful in the further prognostic stratification of such patients. [14][15][16][17][18][19][20][21] However, forming the basis for the present research, the reported results conflicted with the proposed Hgb cut-offs and the true influence of anemia on patients' outcomes, which may have been affected by the significant variations in anemia definitions. [14][15][16][17][18][19][20][21] Our data showed that pre-C-CRT anemia adversely affected the OS (P=0.007), LRPFS (P=0.021), and PFS (P=0.003) outcomes of NPC patients.…”

Section: Discussioncontrasting

confidence: 59%

Baseline hemoglobin <11.0 g/dL has stronger prognostic value than anemia status in nasopharynx cancers treated with chemoradiotherapy

et al. 2019

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Background: To retrospectively investigate the influence of pretreatment anemia and hemoglobin levels on the survival of nasopharyngeal carcinoma patients treated with concurrent chemoradiotherapy (C-CRT). Methods: A total of 149 nasopharyngeal carcinoma patients who received C-CRT were included. All patients had received 70 Gy to the primary tumor plus the involved lymph nodes, and 59.4 Gy and 54 Gy to the intermediate- and low-risk neck regions concurrent with 1–3 cycles of cisplatin. Patients were dichotomized into non-anemic and anemic (hemoglobin <12 g/dL (women) or <13 g/dL (men)) groups according to their pre-treatment hemoglobin measures. Receiver operating characteristic (ROC) curve analysis was utilized for accessibility of a pre-treatment hemoglobin cut-off that impacts outcomes. Potential interactions between baseline anemia status and hemoglobin measures and overall survival, locoregional progression-free survival (LRPFS), and progression-free survival were assessed. Results: Anemia was evident in 36 patients (24.1%), which was related to significantly shorter overall survival ( P=0.007), LRPFS ( P<0.021), and progression-free survival ( P=0.003) times; all three endpoints retained significance in multivariate analyses ( P<0.05, for each). A baseline hemoglobin value of 11.0 g/dL exhibited significant association with outcomes in ROC curve analysis: hemoglobin <11.0 g/dL (N=26) was linked with shorter median overall survival ( P<0.001), LRPFS ( P=0.004), and progression-free survival ( P<0.001) times, which also retained significance for all three endpoints in multivariate analyses and suggested a stronger prognostic worth for the hemoglobin <11.0 g/dL cut-off value than the anemia status. Conclusion: Pre-C-CRT hemoglobin <11.0 g/dL has a stronger prognostic worth than the anemia status with regard to LRPFS, progression-free survival, and overall survival for nasopharyngeal carcinoma patients.

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Section: Discussioncontrasting

confidence: 59%

Baseline hemoglobin <11.0 g/dL has stronger prognostic value than anemia status in nasopharynx cancers treated with chemoradiotherapy

et al. 2019

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“…As a potential biological mechanism, it has been suggested that smoking may stimulate erythropoiesis in a dose-related manner due to hypoxia, which is induced by smoking. In addition, hypoxia is likely to suppress hepcidin expression [8919202122]. …”

Section: Discussionmentioning

confidence: 99%

Associations between Lifestyle Factors and Iron Overload in Korean Adults

2016

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It has been suggested that iron overload, which indicates the accumulation of iron, generates cellular reactive oxygens and causes peroxide damages to the body. Such oxidative stresses, in a broader context, are also caused by lifestyles such as alcohol consumption and smoking. However, there are limited data on the association between these lifestyle factors and internal iron overload. In present study, we evaluated associations between lifestyle factors, such as smoking status, alcohol consumption, and physical activity, and serum markers of iron overload. In a population-based cross-sectional study including 2,347 Korean men and women aged 49–79 years, we assessed serum transferrin saturation (TSAT) levels and defined iron overload as TSAT levels > 50% for men and > 45% for women. After excluding persons with chronic diseases and iron deficiency, multivariate odds ratio (OR) and its 95% confidence interval (CI) were estimated to evaluate associations between lifestyle factors and iron overload in 1,973 participants. In all participants, we examined a significantly positive association between heavy alcohol consumption (> 30 g/day) and iron overload; heavy drinkers showed 1.6-fold higher OR (95% CI, 1.11–2.36) than non-drinkers. Stratified analysis by sex showed that this association was significant only among men. In addition, we observed a potential association between heavy smoking > 10 cigarettes/day and iron overload (p = 0.07). In stratified analysis by sex, we examined a significant association between smoking and iron overload only among women; former or current smokers had 1.9-fold higher OR (95% CI, 1.01–3.63) than never-smoker. Our findings suggest that heavy alcohol consumption and smoking may worsen iron accumulation in the body.

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“…In some studies, post-treatment Hb level was considered to be of predictive value, but the value of pre-treatment Hb level needs to be further confirmed. 37 , 38 In addition, malignant tumors, infections and other factors can also activate the immune and inflammatory system and affect the levels of Hb, NLR and PLR and other parameters. 39 , 40 …”

Section: Discussionmentioning

confidence: 99%

CT-Based Radiomics Nomogram for Prediction of Progression-Free Survival in Locoregionally Advanced Nasopharyngeal Carcinoma

Chang¹,

Shen²,

Chen³

et al. 2021

CMAR

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Purpose We aimed to construct of a nomogram to predict progression-free survival (PFS) in locoregionally advanced nasopharyngeal carcinoma (LA-NPC) with risk stratification using computed tomography (CT) radiomics features and clinical factors. Patients and Methods A total of 311 patients diagnosed with LA-NPC (stage III–IVa) at our hospital between 2010 and 2014 were included. The region of interest (ROI) of the primary nasopharyngeal mass was manually outlined. Independent sample t -test and LASSO-logistic regression were used for selecting the most predictive radiomics features of PFS, and to generate a radiomics signature. A nomogram was built with clinical factors and radiomics features, and the risk stratification model was tested accordingly. Results In total, 20 radiomics features most associated with prognosis were selected. The radiomics nomogram, which integrated the radiomics signature and significant clinical factors, showed excellent performance in predicting PFS, with C-index of 0.873 (95% CI: 0.803~0.943), which was better than that of the clinical nomogram (C-index, 0.729, 95% CI: 0.620~0.838) as well as of the TNM staging system (C-index, 0.689, 95% CI: 0.592–0.787) in validation cohort. The calibration curves and the decision curve analysis (DCA) plot obtained suggested satisfying accuracy and clinical utility of the model. The risk stratification tool was able to predict differences in prognosis of patients in different risk categories ( p <0.001). Conclusion CT-based radiomics features, an in particular, radiomics nomograms, have the potential to become an accurate and reliable tool for assisting with prognosis prediction of LA-NPC.

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The effects of hemoglobin levels and their interactions with cigarette smoking on survival in nasopharyngeal carcinoma patients

Cited by 10 publications

References 40 publications

Baseline hemoglobin <11.0 g/dL has stronger prognostic value than anemia status in nasopharynx cancers treated with chemoradiotherapy

Baseline hemoglobin <11.0 g/dL has stronger prognostic value than anemia status in nasopharynx cancers treated with chemoradiotherapy

Associations between Lifestyle Factors and Iron Overload in Korean Adults

CT-Based Radiomics Nomogram for Prediction of Progression-Free Survival in Locoregionally Advanced Nasopharyngeal Carcinoma

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