Quantitative body mass characterization before and after head and neck cancer radiotherapy: A challenge of height-weight formulae using computed tomography measurement.
We undertook a challenge to determine if one or more height-weight formula(e) can be clinically used as a surrogate for direct CT-based imaging assessment of body composition before and after radiotherapy for head and neck cancer (HNC) patients, who are at risk for cancer- and therapy-associated cachexia/sarcopenia.



This retrospective single-institution study included 215 HNC patients, treated with curative radiotherapy between 2003 and 2013. Height/weight measures were tabulated. Skeletal muscle mass was contoured on pre- and post-treatment CT at the L3 vertebral level. Three common lean body mass (LBM) formulae (Hume, Boer, and James) were calculated, and compared to CT assessment at each time point.



156 patients (73%) had tumors arising in the oropharynx and 130 (61%) received concurrent chemotherapy. Mean pretreatment body mass index (BMI) was 28.5±4.9kg/m(2) in men and 27.8±8kg/m(2) in women. Mean post-treatment BMI were 26.2±4.4kg/m(2) in men, 26±7.5kg/m(2) in women. Mean CT-derived LBM decreased from 55.2±11.8kg pre-therapy to 49.27±9.84kg post-radiation. Methods comparison revealed 95% limit of agreement of ±12.5-13.2kg between CT and height-weight formulae. Post-treatment LBM with the three formulae was significantly different from CT (p<0.0001). In all instances, no height-weight formula was practically equivalent to CT within±5kg.



Formulae cannot accurately substitute for direct quantitative imaging LBM measurements. We therefore recommend CT-based LBM assessment as a routine practice of head and neck cancer patient body composition.
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Radiation Oncology Unit, Chulabhorn Hospital, Bangkok, Thailand.
Sasikarn
S
Chamchod
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: cdfuller@mdanderson.org.
Clifton D
CD
Fuller
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, Alexandria, Egypt. Electronic address: asmohamed@mdanderson.org.
Abdallah S R
AS
Mohamed
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Aaron
A
Grossberg
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; The University of Texas Medical School at Houston, TX, USA.
Jay A
JA
Messer
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Netherlands Cancer Institute, Amsterdam, The Netherlands.
Jolien
J
Heukelom
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
G Brandon
GB
Gunn
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Micheal E
ME
Kantor
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; The University of Texas Medical School at Houston, TX, USA.
Hillary
H
Eichelberger
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Adam S
AS
Garden
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
David I
DI
Rosenthal
D000328:Adult; D000368:Aged; D001835:Body Weight; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D006801:Humans; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
Body composition; Computed tomography; Head and neck cancer; Height- and weight-based mathematical formulas; Lean body mass; Radiotherapy
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