Abstract 919P
Background
Though weight loss (WL) and poor treatment outcomes of chemoradiotherapy (CRT) in locally advanced HNSCC patients was previously reported, nutritional status during CRT has not been well studied. Thus, we prospectively evaluated long term nutritional status of HNSCC patients who underwent CRT and correlated with treatment outcomes.
Methods
Locally advanced HNSCC patients who underwent CRT were enrolled in a prospective observational study. Multiple timepoints of nutritional status such as weight, 24-hour dietary recall, body composition measured by bioelectrical impedance were prospectively collected and analyzed. Significant WL (SWL) was defined as WL≥10% from baseline weight at the time of diagnosis. Safety, tolerability, and treatment outcomes were evaluated.
Results
A total of 130 eligible HNSCC were analyzed. Most patients had nasopharyngeal carcinoma (42%), stage IVa at diagnosis (42%), prophylactic feeding tube (86%), and received definitive CRT (92%) with cisplatin (90%) and IMRT (94%). At mid CRT, patients with SWL (14%) had more grade 3-4 neutropenia (6% vs 3%), acute kidney injury (28% vs 19%), and grade 3-4 mucositis (17% vs 6%). Patients without SWL at mid CRT had significant longer OS (not reach vs 17.8 months; p=0.003) when compared to patients with SWL. In multivariate analysis, SWL at mid CRT was an independent prognostic factor for OS (HR 5.20 [95% CI 2.01-13.48]; p=001). Table: 919P
| Parameter (mean value) | Diagnosis | Mid CRT | End of CRT | 1-mo | 3-mo | 6-mo | 1-yr |
| Weight change (%) | - | -4.3% | -5.0% | -6.0% | -4.3% | -8.5% | -7.4% |
| Body weight (kg) | 60.7 | 57.3 | 57.2 | 58.5 | 57.4 | 60.2 | 60.0 |
| Body mass index (kg/m2) | 22.9 | 21.7 | 21.5 | 22.1 | 22.0 | 22.1 | 24.7 |
| Fat mass (kg) | 15.9 | 15.2 | 14.7 | 14.7 | 14.1 | 14.8 | 16.4 |
| Fat mass (%) | 26.0 | 25.0 | 24.0 | 23.6 | 23.1 | 25.5 | 27.8 |
| Skeletal muscle mass (kg) | 23.4 | 23.0 | 23.4 | 23.2 | 23.1 | 23.1 | 23.8 |
| Skeletal muscle mass (%) | 39.9 | 40.3 | 41.3 | 41.0 | 41.1 | 40.5 | 39.2 |
| Calorie intake (kcal/kg/day) | 30.8 | 32.1 | 36.1 | 36.5 | 36.6 | 35.0 | 32.5 |
| Protein intake (g/kg/day) | 1.19 | 1.37 | 1.42 | 1.39 | 1.37 | 1.4 | 1.23 |
Conclusions
Most patients lost weight during the course of CRT and did not recover after 1 year. Significant WL at mid CRT was observed in 14% of HNSCC patients who underwent CRT. Significant weight loss at mid CRT was an independent factor for OS. Early detection of malnutrition in HNSCC patients who underwent CRT might prevent weight loss, and result in improved OS.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.