title: Prognostic factors in patients with locally advanced head and neck cancer treated with concurrent radiochemotherapy.
abstract: OBJECTIVE
  This study was undertaken to evaluate the association of individual parameters and outcome in patients with unresectable locally advanced head and neck cancer treated with radiochemotherapy.
  
  
  METHODS
  We retrospectively reviewed data from 126 patients treated in our Institution between 1998 and 2010 for a locally advanced head and neck cancer. Sixteen individual parameters were evaluated for association with specific outcomes such as overall survival, persistence of disease, disease-specific survival and disease-free survival.
  
  
  RESULTS
  Six factors influenced overall survival on Kaplan-Meier survival analysis and on univariate Cox regression analysis: smoking, body mass index, site, haemoglobin (Hb) nadir, total dose of radiotherapy and comorbidities. On a multivariate logistic model with stepwise selection, comorbidities, body mass index, total dose and site maintained significance. A significant association for persistence of disease was found with smoking, Hb nadir and site of cancer on univariate and multivariate analysis. Disease-free survival was correlated with performance status, Hb nadir and comorbidities using Kaplan-Meier survival analysis and on univariate Cox regression analysis. Only performance status maintained the significance on multivariate analysis. Disease-specific survival was correlated with five parameters: body mass index, site, Hb nadir, therapy interruption and total dose; on multivariate analysis, Hb nadir, therapy interruption and site maintained a statistically significant association.
  
  
  CONCLUSIONS
  Hb nadir during treatment, body mass index, smoking, stage, comorbidities and performance status are prognostic factors of outcome and response to radical treatment with radiochemotherapy.
authors.affiliation: Department of Radiation-Oncology, University of Florence, Florence, Italy. davide.franceschini@unifi.it.|Department of Radiotherapy, University of Florence, Largo G.A. Brambilla 3, 50134, Florence, Italy. davide.franceschini@unifi.it.
authors.forename: Davide
authors.initials: D
authors.lastname: Franceschini
authors.affiliation: Department of Radiation-Oncology, University of Florence, Florence, Italy.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Paiar
authors.affiliation: Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Center (ISPO), Florence, Italy.
authors.forename: Calogero
authors.initials: C
authors.lastname: Saieva
authors.affiliation: Department of Radiation-Oncology, University of Florence, Florence, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Bonomo
authors.affiliation: Department of Radiation-Oncology, University of Florence, Florence, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Agresti
authors.affiliation: Department of Radiation-Oncology, University of Florence, Florence, Italy.
authors.forename: Icro
authors.initials: I
authors.lastname: Meattini
authors.affiliation: Department of Radiation-Oncology, University of Florence, Florence, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Greto
authors.affiliation: Department of Radiation-Oncology, University of Florence, Florence, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Mangoni
authors.affiliation: Department of Radiation-Oncology, University of Florence, Florence, Italy.
authors.forename: Fiammetta
authors.initials: F
authors.lastname: Meacci
authors.affiliation: Department of Radiation-Oncology, University of Florence, Florence, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Loi
authors.affiliation: Department of Radiation-Oncology, University of Florence, Florence, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Zei
authors.affiliation: Department of Radiation-Oncology, University of Florence, Florence, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Livi
authors.affiliation: Department of Radiation-Oncology, University of Florence, Florence, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Biti
mesh_terms: D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Head and neck; Oncology; Prognostic factors; Radiation therapy