Pretreatment anemia may be predictive of aggressive disease with poor survival and non-local disease progression among patients with early-stage non-small cell lung cancer (NSCLC) undergoing stereotactic body radiation therapy (SBRT), according to a study published in the Journal of Thoracic Oncology.1

Researchers analyzed data from 147 patients with stage I NSCLC who received SBRT. Pretreatment hemoglobin levels were evaluated to determine whether there is an association with local, regional, and distant control, disease-free survival, and overall survival. Another objective was to determine the optimal pretreatment hemoglobin level for predicting poorer outcomes.

Results showed that at a median follow-up of 28.9 months, the 3-year local, regional, and distant control rates were 95%, 87%, and 89%, respectively. The 3-year overall survival rate was 75%, while the 3-year disease-free survival rate was 83%.

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After adjusting for age, T-stage, and radiation dose, researchers found that a lower pretreatment hemoglobin level was associated with poor regional control, poor disease-free survival, and poor overall survival (P = .02, P = .03, P = .05, respectively). Pretreatment anemia did not, however, predict for local disease control.

The study demonstrated that pretreatment hemoglobin levels less than 12.2 g/dL were optimal for predicting poor regional control and disease-free survival. The 3-year disease-free survival for patients with a hemoglobin level less than 12.2 g/dL was 70% compared with 94% among patients with a hemoglobin level of 12.2 g/dL or higher (P = .008).


  1. Shaverdian N, Veruttipong D, Wang J, Kupelian P, Steinberg M, Lee P. Pretreatment anemia portends poor survival and non-local disease progression in stage I non-small cell lung cancer patients treated with stereotactic body radiation therapy [published online ahead of print May 24, 2016]. J Thorac Oncol. doi: 10.1016/j.jtho.2016.04.030.