동시 항암화학방사선요법을 시행 받은 자궁경부암 환자에서 빈혈이 예후에 미치는 영향

Abstract

Objective: Many studies suggested the negative impact of anemia on cervical cancer patients who were treated with radiotherapy. However during the past several years, concurrent chemoradiotherapy was recognized as the standard therapy of locally advanced cervical cancer. The purpose of study was to evaluate the effect of anemia on disease free survival in cervical cancer patients with concurrent chemoradiotherapy.

Methods: 116 patients were selected, who were diagnosed as cervical cancer at Yonsei University Medical Center from October 1998 to June 2003 and treated with concurrent chemoradiotherapy. Medical record was retrospectively reviewed for patient characteristics, hemoglobin, hematocrit and disease free survival. Disease free survival was analysed by univariate analysis, multivariate analysis and Kaplan-Meier method. Patients with hemoglobin value under 10 g/dL, hematocrit value under 30% were considered anemic.

Results: After mean follow up duration of 27 months, among 116 patients, 26 patients experienced recurrence or progression and 10 of these patients died. Univariate and multivariate analysis reveals that stage (P=0.00, P=0.03), lesion size (P=0.01, P=0.01) and the 6th cycle hematocrit (P=0.01, P=0.01) were determinants of disease free survival.

Conclusion: In cervical cancer patients treated with concurrent chemoradiotherapy, initial hemoglobin level was not related to the prognosis. However the higher stage, greater lesion size, and lower level of 6th cycle hematocrit were related to the poor prognosis.