title: Nutritional factors as predictors of response to radio-chemotherapy and survival in unresectable squamous head and neck carcinoma.
abstract: OBJECTIVE
  This study sought to evaluate nutritional prognostic factors before treatment in patients with unresectable head and neck cancer treated by concomitant radio-chemotherapy.
  
  
  METHODS
  Seventy-two consecutive patients were treated. We studied the potential effects of CRP, Alb, preAlb, orosomucoid, weight, weight history, BMI, PINI, OPR and NRI on response to treatment, Event-Free Survival (EFS) and Overall Survival (OS). Effects of potential risk factors on OS and on EFS were analyzed by computing Kaplan-Meier estimates, and curves were compared using the log-rank test.
  
  
  RESULTS
  All biological nutritional factors were statistically correlated with the response to radio-chemotherapy. In multivariate analysis, only CRP (p=0.004) remained statistically significant. A statistical correlation was found between Alb and EFS in multivariate analysis (p=0.04). The factors influencing OS in univariate analysis were Alb (p=0.008), CRP (p=0.004), orosomucoid (p=0.01) and NRI (p=0.01), response to radio-chemotherapy (p<0.001) and staging (p=0.04). In multivariate analysis, only the response to radio-chemotherapy (p<0.001) remained significant.
  
  
  CONCLUSIONS
  This study illustrates the prognostic value of nutritional status. CRP and Alb may be useful in the assessment of advanced head and neck cancer patients at diagnosis and for stratifying patients taking part in randomized trials.
authors.affiliation: Service d'Oncologie Médicale, Adulte CHU Timone, APHM, Marseilles, France. sebastien.salas@ap-hm.fr
authors.forename: Sébastien
authors.initials: S
authors.lastname: Salas
authors.forename: Jean-Laurent
authors.initials: JL
authors.lastname: Deville
authors.forename: Roch
authors.initials: R
authors.lastname: Giorgi
authors.forename: Thierry
authors.initials: T
authors.lastname: Pignon
authors.forename: Danielle
authors.initials: D
authors.lastname: Bagarry
authors.forename: Karine
authors.initials: K
authors.lastname: Barrau
authors.forename: Michel
authors.initials: M
authors.lastname: Zanaret
authors.forename: Antoine
authors.initials: A
authors.lastname: Giovanni
authors.forename: Aude
authors.initials: A
authors.lastname: Bourgeois
authors.forename: Roger
authors.initials: R
authors.lastname: Favre
authors.forename: Florence
authors.initials: F
authors.lastname: Duffaud
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D016190:Carboplatin; D005472:Fluorouracil