The trend of hemoglobin levels in nasopharyngeal cancer patients treated with chemotherapy in low human development index region in Indonesia

Nasopharyngeal cancer (NPC) is a malignant tumor in the epithelial cell of the nasopharynx. Globally, the incidence was around 80,000 new cases annually or it composed 0.7% of cancer cases in the world. In locally advanced cases, chemotherapy and radiotherapy is a treatment of choice for this cancer. Chemotherapy could be given before the radiotherapy, or simultaneous, or after the radiotherapy. Chemotherapy can affect the hemoglobin levels by inducing a suppressive effect on bone marrow and a toxic effect on erythrocytes. Thus, this study aimed to explore the trend of hemoglobin levels in every cycle of chemotherapy in patients with NPC. This study is a retrospective study with secondary data collection of patients with NPC who received chemotherapy at the West Nusa Tenggara, one of the regions with low human development index (HDI) in Indonesia, during the period 2017-2019. The data obtained were analyzed descriptively and repeated measurement ANOVA test to explore the difference of hemoglobin levels during every cycle of chemotherapy. The results showed a trend of decreasing mean hemoglobin levels in six series of chemotherapy, with p-value = 0.06 on repeated measurement test. There was a trend of decreasing mean haemoglobin levels in patients with nasopharyngeal cancer who received chemotherapy in low HDI region in Indonesia.