title: Impact of weight loss on survival after chemoradiation for locally advanced head and neck cancer: secondary results of a randomized phase III trial (SAKK 10/94).
abstract: BACKGROUND
  To analyze the impact of weight loss before and during chemoradiation on survival outcomes in patients with locally advanced head and neck cancer.
  
  
  METHODS
  From 07/1994-07/2000 a total of 224 patients with squamous cell carcinoma of the head and neck were randomized to either hyperfractionated radiation therapy alone or the same radiation therapy combined with two cycles of concomitant cisplatin. The primary endpoint was time to any treatment failure (TTF); secondary endpoints were locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS) and overall survival (OS). Patient weight was measured 6 months before treatment, at treatment start and treatment end.
  
  
  RESULTS
  The proportion of patients with >5% weight loss was 32% before, and 51% during treatment, and the proportion of patients with >10% weight loss was 12% before, and 17% during treatment. After a median follow-up of 9.5 years (range, 0.1 - 15.4 years) weight loss before treatment was associated with decreased TTF, LRRFS, DMFS, cancer specific survival and OS in a multivariable analysis. However, weight loss during treatment was not associated with survival outcomes.
  
  
  CONCLUSIONS
  Weight loss before and during chemoradiation was commonly observed. Weight loss before but not during treatment was associated with worse survival.
authors: Pirus
authors: P
authors: Ghadjar
authors: Stefanie
authors: S
authors: Hayoz
authors: Frank
authors: F
authors: Zimmermann
authors: Stephan
authors: S
authors: Bodis
authors: David
authors: D
authors: Kaul
authors: Harun
authors: H
authors: Badakhshi
authors: Jacques
authors: J
authors: Bernier
authors: Gabriela
authors: G
authors: Studer
authors: Ludwig
authors: L
authors: Plasswilm
authors: Volker
authors: V
authors: Budach
authors: Daniel M
authors: DM
authors: Aebersold
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000628:therapy*; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D000077195:Squamous Cell Carcinoma of Head and Neck; D015431:Weight Loss