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Pretreatment weight status and weight loss among head and neck cancer patients receiving definitive concurrent chemoradiation therapy: implications for nutrition integrated treatment pathways

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Abstract

Purpose

The purpose was to examine the effect of pretreatment weight status on loco-regional progression for patients with squamous cell carcinoma of the head and neck (SCCHN) after receiving definitive concurrent chemoradiation therapy (CCRT).

Methods

In an expanded cohort of 140 patients, we retrospectively reviewed weight status and loco-regional progression of SCCHN patients treated with CCRT between 2004 and 2010.

Results

Pretreatment ideal body weight percentage (IBW%) was statistically significantly different for patients with disease progression than for those without progression (p = 0.02) but was not an independent predictor of progression. Median pretreatment IBW% was 118 (72–193) for the progression-free group and was 101.5 (73–163) for the group with progression. Both groups suffered clinically severe weight loss of approximately 9 % from baseline to end treatment.

Conclusions

Pretreatment weight status, a very crude indicator of nutrition status, may have prognostic value in patients with SCCHN undergoing definitive CCRT. Inadequate nutritional status in these patients has been associated with poor clinical outcomes and decreased quality of life. Based on this report and others, the best next steps include routine validated malnutrition screening and the testing of evidence-based nutrition care protocols with the goals of minimizing weight loss and improvement of quality of life.

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Acknowledgments

This work was funded in part by the National Institutes of Health grant number R25CA114101.

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Authors and Affiliations

  1. Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, NY, USA

    Mary E. Platek & Elizabeth Myrick

  2. Department of Nutrition, Food Studies and Public Health, New York University, 411 Lafayette Street, New York, NY, 10003, USA

    Mary E. Platek

  3. Department of Radiation Oncology, University of California, Los Angeles, CA, USA

    Susan A. McCloskey

  4. Department of Head and Neck/Plastic Surgery, Roswell Park Cancer Institute, Buffalo, NY, USA

    Vishal Gupta, David Cohan, Hassan Arshad, Nestor R. Rigual & Wesley L. Hicks Jr.

  5. Departments of Medicine and Cancer Prevention, Roswell Park Cancer Institute, Buffalo, NY, USA

    Mary E. Reid

  6. Department of Biostatistics, The State University of New York at Buffalo, Buffalo, NY, USA

    Gregory E. Wilding

  7. Department of Dentistry and Maxillofacial Prosthetics, Roswell Park Cancer Institute, Buffalo, NY, USA

    Maureen Sullivan

  8. Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA

    Graham W. Warren & Anurag K. Singh

Authors
  1. Mary E. Platek
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  2. Elizabeth Myrick
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  3. Susan A. McCloskey
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  4. Vishal Gupta
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  5. Mary E. Reid
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  6. Gregory E. Wilding
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  7. David Cohan
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  8. Hassan Arshad
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  9. Nestor R. Rigual
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  11. Maureen Sullivan
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  13. Anurag K. Singh
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Correspondence to Mary E. Platek.

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Platek, M.E., Myrick, E., McCloskey, S.A. et al. Pretreatment weight status and weight loss among head and neck cancer patients receiving definitive concurrent chemoradiation therapy: implications for nutrition integrated treatment pathways. Support Care Cancer 21, 2825–2833 (2013). https://doi.org/10.1007/s00520-013-1861-0

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  • DOI: https://doi.org/10.1007/s00520-013-1861-0

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