ICHNO-ECHNO 2022 - Abstract Book

S99

ICHNO-ECHNO 2022

Purpose or Objective Tumour hypoxia is a poor prognostic factor, and correlates with haemoglobin (Hb) levels. For anaemic patients receiving radical radiotherapy, packed red cell (PRC) transfusions are given to improve tumour oxygenation and avoid treatment resistance. The results of randomised controlled trials (RCTs) suggest that transfusion use worsens survival, though the reasons are poorly understood. We investigated the relationship between Hb dynamics, PRC transfusions and overall survival (OS). Materials and Methods This was an observational study of consecutive patients with oropharynx squamous cell carcinoma treated by curative intent radiotherapy, with or without concurrent chemotherapy (n = 778). Details of PRC transfusion was recorded for the period from 3 weeks prior to radiotherapy to the end of radiotherapy. Hb values were recorded for the same time period and used to derive Hb decay. Previously determined prognostic factors (patient age, ECOG performance status, ACE 27 co-morbidity index score, smoking history, TNMv8 stage group and concurrent cisplatin use) were used in a multivariable Cox proportional hazards analysis to assess the prognostic importance of pre-treatment Hb, Hb decay and the interaction between these parameters and PRC transfusion. The primary endpoint was OS. Results On univariable analysis, a higher pre-radiotherapy Hb value was associated with an OS benefit (hazard ratio [HR] 0.84, 95% confidence interval [CI] 0.76-0.92, p < 0.001). PRC transfusion was associated with inferior OS (HR 1.63, 95% CI 1.09-2.44, p = 0.018) as was faster Hb decay (HR 3.01, 95% CI 1.36-6.71, p = 0.007) (Table 1). There was a significant interaction between Hb decay and PRC transfusion: for patients receiving a transfusion, the faster the rate of Hb decline, the poorer their prognosis (HR 44.3, 95% CI 3.83-513, p = 0.002) (Table 2). No interaction was found between the pre-specified prognostic factors above and pre-radiotherapy Hb, Hb decay or the need for PRC transfusion.

Conclusion For patients receiving PRC transfusions, the faster the rate of Hb decay, the poorer the prognosis. This finding suggests that anaemic patients receive an inadequate number of PRC units and that a more liberal transfusion strategy may be required.

PO-0160 Geriatric assessment and response to quality of life questionnaires in head and neck cancer

G. Halmos 1 , J. de Vries 1 , D. Vermue 1 , G. de Bock 2 , R. Steenbakkers 3 , S. Festen 4

1 University Medical Center Groningen, University of Groningen, Otolaryngology, Head and Neck Surgery, Groningen, The Netherlands; 2 University Medical Center Groningen, University of Groningen, Epidemiology, Groningen, The Netherlands; 3 University Medical Center Groningen, University of Groningen, Radiation Oncology, Groningen, The Netherlands; 4 University Medical Center Groningen, University of Groningen, University Center for Geriatric Medicine, Groningen, The Netherlands Purpose or Objective To determine geriatric factors associated with response to quality of life questionnaires (QLQ) in head and neck cancer (HNC) patients.