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Weight Loss and other Adverse 0utcomes for Head and Neck Cancer Patients Undergoing Treatment
Author(s) -
Hertroijs Dorijn,
Platek Mary,
Singh Anurag
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.864.2
Subject(s) - medicine , dysphagia , weight loss , head and neck cancer , percutaneous endoscopic gastrostomy , malnutrition , cancer , parenteral nutrition , feeding tube , gastrostomy , surgery , peg ratio , obesity , finance , economics
Purpose To describe the prevalence of weight loss, dysphagia and esophageal stricture in patients with squamous cell carcinoma of the head and neck (SCCHN) undergoing concurrent chemoradiation (CCRT) and to examine pretreatment weight status as a predictor of local regional progression (LRP). Methods Retrospective review of 140 SCCHN patients definitively treated with CCRT from 2004 through 2010 at Roswell Park Cancer Institute. Patients were offered a percutaneous endoscopic gastrostomy (PEG) tube. Nutrition follow‐up was by referral only. Patient information was collected from the electronic medical record. Results Approximately 93% had dysphagia, 19% had esophageal stricture and 22% with strictures required dilatation. Median pretreatment ideal body weight percentage (IBW%) was significantly different between patients without LRP (118%) and with LRP (n=18) (101.5%) (p=0.02), but was not an independent predictor of LRP when tested in a multivariate regression model. Both groups suffered weight loss of 9% during treatment despite nutrition support. Conclusions Pretreatment weight status, a very crude indicator of nutrition status, was not an independent predictor of LRP but may have prognostic value. Next steps include validated malnutrition screening and the testing of evidence based nutrition protocols to minimize weight loss and manage dysphagia. Research support: Nutritional Cancer Institute