Impact of weight loss on survival after chemoradiation for locally advanced head and neck Cancer: secondary results of a randomized phase III trial (SAKK 10/94)

Radiation Oncology

Daniel M Aebersold¹  Volker Budach⁴  Ludwig Plasswilm³  Gabriela Studer²  Jacques Bernier⁶  Harun Badakhshi⁴  David Kaul⁴  Stephan Bodis⁵  Frank Zimmermann⁷  Stefanie Hayoz⁸  Pirus Ghadjar⁴ 

[1] Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland;Department of Radiation Oncology, University Hospital Zürich, Zürich, Switzerland;Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland;Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany;Department of Radiation Oncology, Kantonsspital Aarau, Aarau, Switzerland;Department of Radiation Oncology, Clinique de Genolier, Genolier, Switzerland;Department of Radiation Oncology, University Hospital Basel, Basel, Switzerland;SAKK Coordinating Center, Bern, Switzerland

关键词: Malnutrition;    Survival;    Hyperfractionated radiation therapy;    Head and neck cancer;    Cisplatin;    Chemotherapy;    Weight loss;   

Others  :  1149970
DOI  :  10.1186/s13014-014-0319-y

 received in 2014-11-10, accepted in 2014-12-22,  发布年份 2015

【 摘 要 】

Background

To analyze the impact of weight loss before and during chemoradiation on survival outcomes in patients with locally advanced head and neck cancer.

Methods

From 07/1994-07/2000 a total of 224 patients with squamous cell carcinoma of the head and neck were randomized to either hyperfractionated radiation therapy alone or the same radiation therapy combined with two cycles of concomitant cisplatin. The primary endpoint was time to any treatment failure (TTF); secondary endpoints were locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS) and overall survival (OS). Patient weight was measured 6 months before treatment, at treatment start and treatment end.

Results

The proportion of patients with >5% weight loss was 32% before, and 51% during treatment, and the proportion of patients with >10% weight loss was 12% before, and 17% during treatment. After a median follow-up of 9.5 years (range, 0.1 – 15.4 years) weight loss before treatment was associated with decreased TTF, LRRFS, DMFS, cancer specific survival and OS in a multivariable analysis. However, weight loss during treatment was not associated with survival outcomes.

Conclusions

Weight loss before and during chemoradiation was commonly observed. Weight loss before but not during treatment was associated with worse survival.

【 授权许可】

   
2015 Ghadjar et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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