Cargando…
Critical weight loss is a major prognostic indicator for disease-specific survival in patients with head and neck cancer receiving radiotherapy
BACKGROUND: Pre-treatment weight loss (WL) is a prognostic indicator for overall survival (OS) in head and neck cancer (HNC) patients. This study investigates the association between WL before or during radiotherapy and disease-specific survival (DSS) in HNC patients. METHODS: In 1340 newly diagnose...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group
2013
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3778304/ https://www.ncbi.nlm.nih.gov/pubmed/23928661 http://dx.doi.org/10.1038/bjc.2013.458 |
_version_ | 1782285092252549120 |
---|---|
author | Langius, J A E Bakker, S Rietveld, D H F Kruizenga, H M Langendijk, J A Weijs, P J M Leemans, C R |
author_facet | Langius, J A E Bakker, S Rietveld, D H F Kruizenga, H M Langendijk, J A Weijs, P J M Leemans, C R |
author_sort | Langius, J A E |
collection | PubMed |
description | BACKGROUND: Pre-treatment weight loss (WL) is a prognostic indicator for overall survival (OS) in head and neck cancer (HNC) patients. This study investigates the association between WL before or during radiotherapy and disease-specific survival (DSS) in HNC patients. METHODS: In 1340 newly diagnosed HNC patients, weight change was collected before and during (adjuvant) radiotherapy with curative intent. Critical WL during radiotherapy was defined as >5% WL during radiotherapy or >7.5% WL until week 12. Differences in 5-year OS and DSS between WL groups were analysed by Cox's regression with adjustments for important socio-demographic and tumour-related confounders. RESULTS: Before radiotherapy, 70% of patients had no WL, 16% had ⩽5% WL, 9% had >5–10% WL, and 5% had >10% WL. Five-year OS and DSS rates for these groups were 71%, 59%, 47%, and 42% (P<0.001), and 86%, 86%, 81%, and 71%, respectively (P<0.001). After adjustment for potential confounders, >10% WL before radiotherapy remained significantly associated with a worse OS (HR 1.7; 95% CI 1.2–2.5; P=0.002) and DSS (HR 2.1; 95% CI 1.2–3.5; P=0.007). The 5-year OS and DSS rates for patients with critical WL during radiotherapy were 62% and 82%, compared with 70% and 89% for patients without critical WL (P=0.01; P=0.001). After adjustment, critical WL during radiotherapy remained significantly associated with a worse DSS (HR 1.7; 95% CI 1.2–2.4; P=0.004). CONCLUSION: Weight loss both before and during radiotherapy are important prognostic indicators for 5-year DSS in HNC patients. Randomised studies into the prognostic effect of nutritional intervention are needed. |
format | Online Article Text |
id | pubmed-3778304 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-37783042014-09-03 Critical weight loss is a major prognostic indicator for disease-specific survival in patients with head and neck cancer receiving radiotherapy Langius, J A E Bakker, S Rietveld, D H F Kruizenga, H M Langendijk, J A Weijs, P J M Leemans, C R Br J Cancer Clinical Study BACKGROUND: Pre-treatment weight loss (WL) is a prognostic indicator for overall survival (OS) in head and neck cancer (HNC) patients. This study investigates the association between WL before or during radiotherapy and disease-specific survival (DSS) in HNC patients. METHODS: In 1340 newly diagnosed HNC patients, weight change was collected before and during (adjuvant) radiotherapy with curative intent. Critical WL during radiotherapy was defined as >5% WL during radiotherapy or >7.5% WL until week 12. Differences in 5-year OS and DSS between WL groups were analysed by Cox's regression with adjustments for important socio-demographic and tumour-related confounders. RESULTS: Before radiotherapy, 70% of patients had no WL, 16% had ⩽5% WL, 9% had >5–10% WL, and 5% had >10% WL. Five-year OS and DSS rates for these groups were 71%, 59%, 47%, and 42% (P<0.001), and 86%, 86%, 81%, and 71%, respectively (P<0.001). After adjustment for potential confounders, >10% WL before radiotherapy remained significantly associated with a worse OS (HR 1.7; 95% CI 1.2–2.5; P=0.002) and DSS (HR 2.1; 95% CI 1.2–3.5; P=0.007). The 5-year OS and DSS rates for patients with critical WL during radiotherapy were 62% and 82%, compared with 70% and 89% for patients without critical WL (P=0.01; P=0.001). After adjustment, critical WL during radiotherapy remained significantly associated with a worse DSS (HR 1.7; 95% CI 1.2–2.4; P=0.004). CONCLUSION: Weight loss both before and during radiotherapy are important prognostic indicators for 5-year DSS in HNC patients. Randomised studies into the prognostic effect of nutritional intervention are needed. Nature Publishing Group 2013-09-03 2013-08-08 /pmc/articles/PMC3778304/ /pubmed/23928661 http://dx.doi.org/10.1038/bjc.2013.458 Text en Copyright © 2013 Cancer Research UK http://creativecommons.org/licenses/by-nc-sa/3.0/ From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/ |
spellingShingle | Clinical Study Langius, J A E Bakker, S Rietveld, D H F Kruizenga, H M Langendijk, J A Weijs, P J M Leemans, C R Critical weight loss is a major prognostic indicator for disease-specific survival in patients with head and neck cancer receiving radiotherapy |
title | Critical weight loss is a major prognostic indicator for disease-specific survival in patients with head and neck cancer receiving radiotherapy |
title_full | Critical weight loss is a major prognostic indicator for disease-specific survival in patients with head and neck cancer receiving radiotherapy |
title_fullStr | Critical weight loss is a major prognostic indicator for disease-specific survival in patients with head and neck cancer receiving radiotherapy |
title_full_unstemmed | Critical weight loss is a major prognostic indicator for disease-specific survival in patients with head and neck cancer receiving radiotherapy |
title_short | Critical weight loss is a major prognostic indicator for disease-specific survival in patients with head and neck cancer receiving radiotherapy |
title_sort | critical weight loss is a major prognostic indicator for disease-specific survival in patients with head and neck cancer receiving radiotherapy |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3778304/ https://www.ncbi.nlm.nih.gov/pubmed/23928661 http://dx.doi.org/10.1038/bjc.2013.458 |
work_keys_str_mv | AT langiusjae criticalweightlossisamajorprognosticindicatorfordiseasespecificsurvivalinpatientswithheadandneckcancerreceivingradiotherapy AT bakkers criticalweightlossisamajorprognosticindicatorfordiseasespecificsurvivalinpatientswithheadandneckcancerreceivingradiotherapy AT rietvelddhf criticalweightlossisamajorprognosticindicatorfordiseasespecificsurvivalinpatientswithheadandneckcancerreceivingradiotherapy AT kruizengahm criticalweightlossisamajorprognosticindicatorfordiseasespecificsurvivalinpatientswithheadandneckcancerreceivingradiotherapy AT langendijkja criticalweightlossisamajorprognosticindicatorfordiseasespecificsurvivalinpatientswithheadandneckcancerreceivingradiotherapy AT weijspjm criticalweightlossisamajorprognosticindicatorfordiseasespecificsurvivalinpatientswithheadandneckcancerreceivingradiotherapy AT leemanscr criticalweightlossisamajorprognosticindicatorfordiseasespecificsurvivalinpatientswithheadandneckcancerreceivingradiotherapy |