Influence of weight loss on outcomes in patients with head and neck cancer undergoing concomitant chemoradiotherapy

Head Neck. 2008 Apr;30(4):503-8. doi: 10.1002/hed.20737.

Abstract

Background: The purpose of this study was to determine the influence of weight loss on outcome in patients with head and neck cancer undergoing concomitant chemoradiotherapy (CCRT): treatment interruption, infections, mortality, and hospital readmission rate.

Methods: Forty patients with head and neck cancer were enrolled. All patients were counseled to follow a nutritional program during CCRT. Body weight was evaluated at baseline, at the end, and 30 days after radiochemotherapy.

Results: Ninety percent of compliant patients with nutritional program maintained body weight (mean, 1 +/- 2.4 kg) and 100% of noncompliant patients continued to lose weight (mean, -9 +/- 4 kg; p < .001). A reduction greater than 20% of prediagnosis weight significantly correlated with treatment interruption (p = .003), infections (p = .002), early mortality (p = .011), hospital readmission rate (p = .001), and survival (log-rank test: z = -2.722, p = .006).

Conclusion: In patients with head and neck cancer undergoing CCRT, the early nutritional management reduces weight loss and improve outcome.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bacterial Infections / complications
  • Candidiasis / complications
  • Counseling
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Male
  • Middle Aged
  • Nutritional Requirements
  • Nutritional Status*
  • Nutritional Support
  • Outcome Assessment, Health Care*
  • Patient Compliance*
  • Patient Readmission / statistics & numerical data
  • Prealbumin / analysis
  • Survival Analysis
  • Weight Loss*

Substances

  • Prealbumin