Pretreatment body mass index as an independent prognostic factor in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy: findings from a randomised trial

Eur J Cancer. 2013 May;49(8):1923-31. doi: 10.1016/j.ejca.2013.01.027. Epub 2013 Feb 21.

Abstract

Objective: To investigate the relationship between the pretreatment body mass index (BMI) and the clinical outcomes in patients with locoregionally advanced nasopharyngeal carcinoma treated with combination of chemotherapy and radiotherapy.

Methods: From August 2002 to April 2005, 400 patients with stage III or stage IVa nasopharyngeal carcinoma were recruited for a randomised clinical trial of induction chemotherapy combined with radiotherapy or concurrent chemoradiotherapy. The patients were divided into four groups of underweight (BMI<18.5kg/m(2)), normal weight (BMI 18.5-22.9kg/m(2)), overweight (BMI 23.0-27.4kg/m(2)) or obese (BMI≥27.5kg/m(2)) according to the World Health Organization classifications for Asian populations. The differences in the long-term survival, of these four BMI groups were analysed.

Results: The 5-year failure-free survival rates for the underweight, normal weight, overweight and obese groups were 44%, 61%, 68% and 73%, respectively (p=0.014), and the 5-year overall survival rates were 51%, 68%, 80% and 72% (p=0.001), respectively. BMI was a strongly favoured prognostic factor of overall survival and failure-free survival in a Cox regression model.

Conclusions: Pretreatment body mass index was a simple, reliable independent prognostic factor for patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Body Mass Index*
  • Body Weight
  • Chemoradiotherapy / adverse effects
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Leukopenia / etiology
  • Male
  • Middle Aged
  • Mucositis / etiology
  • Multivariate Analysis
  • Nasopharyngeal Neoplasms / pathology
  • Nasopharyngeal Neoplasms / therapy*
  • Nasopharynx / drug effects*
  • Nasopharynx / pathology
  • Nasopharynx / radiation effects*
  • Neoplasm Staging
  • Outcome Assessment, Health Care / statistics & numerical data
  • Overweight
  • Prognosis
  • Proportional Hazards Models
  • Randomized Controlled Trials as Topic
  • Young Adult