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Clinical Trial
. 2015 Jan 17:10:21.
doi: 10.1186/s13014-014-0319-y.

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)

Pirus Ghadjar, Stefanie Hayoz, Frank Zimmermann, Stephan Bodis, David Kaul, Harun Badakhshi, Jacques Bernier, Gabriela Studer, Ludwig Plasswilm, Volker Budach, Daniel M Aebersold; Swiss Group for Clinical Cancer Research (SAKK)
Clinical Trial

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)

Pirus Ghadjar et al. Radiat Oncol. .

Abstract

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.

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Figures

Figure 1
Figure 1
Kaplan Meier plots showing patients with weight loss before and during treatment and time to any treatment failure (A,B) locoregional failure-free survival (C,D) and distant metastasis-free survival (E,F) over 9.5 years median follow-up stratified according to the magnitude of weight loss.
Figure 2
Figure 2
Kaplan Meier plots showing patients with weight loss before and during treatment and cancer specific survival (A,B) and overall survival (C,D) over 9.5 years median follow-up stratified according to the magnitude of weight loss.
See this image and copyright information in PMC

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