In:
Cancer Medicine, Wiley, Vol. 7, No. 5 ( 2018-05), p. 1630-1641
Abstract:
We aimed to determine whether body composition assessment before treatment can predict outcomes in patients with head and neck cancer ( HNC ). All 881 patients with locoregional head and neck cancer treated with curative intent radiotherapy ( RT ) between 2005 and 2012 were retrospectively investigated. Body composition was analyzed via pre‐ RT planning computed tomography ( CT ) images. Subcutaneous adipose tissue ( SAT ) and skeletal muscle ( SM ) indices were measured cross‐sectionally at the level of the third thoracic vertebra. Overall survival ( OS ), locoregional control ( LRC ), and distant metastasis‐free survival ( MFS ) were analyzed by body composition index and body mass index ( BMI ). Survivors were followed up for a median of 4.68 years. The SAT indices in female patients were significantly higher than those in males ( P 〈 0.001). The median SAT and muscle indices were 18.6 and 34.3 cm 2 /m 2 for women and 6.19 and 51.74 cm 2 /m 2 for men, respectively. The 5‐ and 10‐year MFS , LRC , and OS rates were 83% and 82.1%, 73.4% and 71.4%, and 66.4 and 57.6%, respectively. Higher pretreatment SAT index was associated with MFS (hazard ratio [ HR ]: 0.65; P = 0.015), LRC ( HR : 0.758; P = 0.047), and OS ( HR : 0.604; P 〈 0.001). Higher pretreatment BMI was associated with MFS ( HR : 0.642; P = 0.031) and OS ( HR : 0.615; P 〈 0.001). The pretreatment SM index had no significant effect on MFS , LRC , and OS . Multivariate analysis revealed that T‐stage, N‐stage, lesion sites, age, and RT treatment days are independent factors associated with OS ; T‐stage, N‐stage, and lesion sites are independent factors associated with MFS ; and N‐stage, smoking history, and betel quid chewing history are independent factors associated with LRC . A higher CT ‐assessed SAT index predicts superior MSF , LCR , and OS in patients with curative HNC , whereas SM does not predict survival or locoregional control.
Type of Medium:
Online Resource
ISSN:
2045-7634
,
2045-7634
DOI:
10.1002/cam4.2018.7.issue-5
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2659751-2
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