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Pretreatment performance status and nutrition are associated with early mortality of locally advanced head and neck cancer patients undergoing concurrent chemoradiation

  • Head and Neck
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Abstract

Unexpected fatal events in patients with head and neck cancers undergoing concurrent chemoradiation therapy are a clinical concern. Malnutrition, which is reported frequently in head and neck cancer patients, are associated with immunity derangement. The purpose of this study was to identify risk factors for early death of patients undergoing chemoradiation. We retrospectively analyzed the records of 194 stage III, IVA, and IVB head and neck cancer patients who were treated with chemoradiation between 2007 and 2009. We defined early death as death while receiving chemoradiation or within 60 days of treatment completion. Risk factors for early death were tested using univariate and multivariate analyses. Fourteen patients (7.2 %) experienced early death, 78.6 % of whom died of infection. Univariate analysis revealed significant correlations between early death and several pretreatment variables, including Eastern Cooperative Oncology Group performance status (PS) >1, hemoglobin <10 g/dL, albumin <3 g/dL, body mass index (BMI) <19 kg/m2, and peripheral blood total lymphocyte count <700/μL. Multivariate analysis showed that PS >1, BMI <19 kg/m2, and peripheral blood total lymphocyte count <700/μL were independent variables associated with early death. Poor performance status and malnutrition before chemoradiation independently predict early death in locally advanced head and neck cancer patients undergoing chemoradiation. Cautious management of head and neck cancer patients with these risk factors is required throughout chemoradiation period.

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Acknowledgments

The authors thank all the members of the Cancer center, Chang Gung Memorial Hospital, Keelung, for their invaluable help. The authors would also like to thank Wei-Jhih Wang for the assistance in the data collection and statistics analysis.

Conflict of interest

The authors declare that they have no competing interests and no financial relationship with other organizations sponsoring this research. All authors have nothing to disclose.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, 200, Lane 208, Jijin 1st Road, Keelung, 20445, Taiwan

    Pei-Hung Chang, Kun-Yun Yeh, Jen-Seng Huang, Chien-Hong Lai, Tsung-Han Wu, Yii-Jenq Lan & Cheng-Hsu Wang

  2. Department of Radiation Oncology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, 200, Lane 208, Jijin 1st Road, Keelung, 20445, Taiwan

    Jason Chien-Sheng Tsai & Eric Yen-Chao Chen

  3. Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, 200, Lane 208, Jijin 1st Road, Keelung, 20445, Taiwan

    Shih-Wei Yang

  4. Cancer Center, Chang Gung Memorial Hospital, Keelung, Taiwan

    Cheng-Hsu Wang

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  1. Pei-Hung Chang
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  2. Kun-Yun Yeh
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Correspondence to Cheng-Hsu Wang.

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Chang, PH., Yeh, KY., Huang, JS. et al. Pretreatment performance status and nutrition are associated with early mortality of locally advanced head and neck cancer patients undergoing concurrent chemoradiation. Eur Arch Otorhinolaryngol 270, 1909–1915 (2013). https://doi.org/10.1007/s00405-012-2290-2

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  • DOI: https://doi.org/10.1007/s00405-012-2290-2

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