Pretreatment subcutaneous adipose tissue predicts the outcomes of patients with head and neck cancer receiving definitive radiation and chemoradiation in Taiwan
Abstract We aimed to determine whether body composition assessment before treatment can predict outcomes in patients with head and neck cancer (HNC). All 881 patients with locoregional head and neck cancer treated with curative intent radiotherapy (RT) between 2005 and 2012 were retrospectively inve...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-05-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.1365 |
| _version_ | 1827993456015835136 |
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| author | Ping Ching Pai Chi Cheng Chuang Wen Ching Chuang Ngan Ming Tsang Chen Kan Tseng Kuan Hung Chen Tzu Chen Yen Chien Yu Lin Kai Ping Chang Kin Fong Lei |
| author_facet | Ping Ching Pai Chi Cheng Chuang Wen Ching Chuang Ngan Ming Tsang Chen Kan Tseng Kuan Hung Chen Tzu Chen Yen Chien Yu Lin Kai Ping Chang Kin Fong Lei |
| author_sort | Ping Ching Pai |
| collection | DOAJ |
| description | Abstract We aimed to determine whether body composition assessment before treatment can predict outcomes in patients with head and neck cancer (HNC). All 881 patients with locoregional head and neck cancer treated with curative intent radiotherapy (RT) between 2005 and 2012 were retrospectively investigated. Body composition was analyzed via pre‐RT planning computed tomography (CT) images. Subcutaneous adipose tissue (SAT) and skeletal muscle (SM) indices were measured cross‐sectionally at the level of the third thoracic vertebra. Overall survival (OS), locoregional control (LRC), and distant metastasis‐free survival (MFS) were analyzed by body composition index and body mass index (BMI). Survivors were followed up for a median of 4.68 years. The SAT indices in female patients were significantly higher than those in males (P < 0.001). The median SAT and muscle indices were 18.6 and 34.3 cm2/m2 for women and 6.19 and 51.74 cm2/m2 for men, respectively. The 5‐ and 10‐year MFS, LRC, and OS rates were 83% and 82.1%, 73.4% and 71.4%, and 66.4 and 57.6%, respectively. Higher pretreatment SAT index was associated with MFS (hazard ratio [HR]: 0.65; P = 0.015), LRC (HR: 0.758; P = 0.047), and OS (HR: 0.604; P < 0.001). Higher pretreatment BMI was associated with MFS (HR: 0.642; P = 0.031) and OS (HR: 0.615; P < 0.001). The pretreatment SM index had no significant effect on MFS, LRC, and OS. Multivariate analysis revealed that T‐stage, N‐stage, lesion sites, age, and RT treatment days are independent factors associated with OS; T‐stage, N‐stage, and lesion sites are independent factors associated with MFS; and N‐stage, smoking history, and betel quid chewing history are independent factors associated with LRC. A higher CT‐assessed SAT index predicts superior MSF, LCR, and OS in patients with curative HNC, whereas SM does not predict survival or locoregional control. |
| first_indexed | 2024-04-10T04:25:17Z |
| format | Article |
| id | doaj.art-99c47de46a0845a7816ae8a65b9707cf |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-10T04:25:17Z |
| publishDate | 2018-05-01 |
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| series | Cancer Medicine |
| spelling | doaj.art-99c47de46a0845a7816ae8a65b9707cf2023-03-10T15:42:21ZengWileyCancer Medicine2045-76342018-05-01751630164110.1002/cam4.1365Pretreatment subcutaneous adipose tissue predicts the outcomes of patients with head and neck cancer receiving definitive radiation and chemoradiation in TaiwanPing Ching Pai0Chi Cheng Chuang1Wen Ching Chuang2Ngan Ming Tsang3Chen Kan Tseng4Kuan Hung Chen5Tzu Chen Yen6Chien Yu Lin7Kai Ping Chang8Kin Fong Lei9Department of Radiation Oncology Chang Gung Memorial Hospital and University at Lin‐Kou Taoyuan TaiwanDepartment of Neurosurgery Chang Gung Memorial Hospital and University at Lin‐Kou Taoyuan TaiwanSchool of Medicine Chang Gung University Taoyuan TaiwanDepartment of Radiation Oncology Chang Gung Memorial Hospital and University at Lin‐Kou Taoyuan TaiwanDepartment of Radiation Oncology Chang Gung Memorial Hospital and University at Lin‐Kou Taoyuan TaiwanSchool of Medicine Chang Gung University Taoyuan TaiwanDepartments of Nuclear Medicine and Molecular Imaging Center Chang Gung Memorial Hospital and University at Lin‐Kou Taoyuan TaiwanDepartment of Radiation Oncology Chang Gung Memorial Hospital and University at Lin‐Kou Taoyuan TaiwanDepartment of Otolaryngology‐Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University at Lin‐Kou Taoyuan TaiwanGraduate Institute of Medical Mechatronics Chang Gung University Taoyuan TaiwanAbstract We aimed to determine whether body composition assessment before treatment can predict outcomes in patients with head and neck cancer (HNC). All 881 patients with locoregional head and neck cancer treated with curative intent radiotherapy (RT) between 2005 and 2012 were retrospectively investigated. Body composition was analyzed via pre‐RT planning computed tomography (CT) images. Subcutaneous adipose tissue (SAT) and skeletal muscle (SM) indices were measured cross‐sectionally at the level of the third thoracic vertebra. Overall survival (OS), locoregional control (LRC), and distant metastasis‐free survival (MFS) were analyzed by body composition index and body mass index (BMI). Survivors were followed up for a median of 4.68 years. The SAT indices in female patients were significantly higher than those in males (P < 0.001). The median SAT and muscle indices were 18.6 and 34.3 cm2/m2 for women and 6.19 and 51.74 cm2/m2 for men, respectively. The 5‐ and 10‐year MFS, LRC, and OS rates were 83% and 82.1%, 73.4% and 71.4%, and 66.4 and 57.6%, respectively. Higher pretreatment SAT index was associated with MFS (hazard ratio [HR]: 0.65; P = 0.015), LRC (HR: 0.758; P = 0.047), and OS (HR: 0.604; P < 0.001). Higher pretreatment BMI was associated with MFS (HR: 0.642; P = 0.031) and OS (HR: 0.615; P < 0.001). The pretreatment SM index had no significant effect on MFS, LRC, and OS. Multivariate analysis revealed that T‐stage, N‐stage, lesion sites, age, and RT treatment days are independent factors associated with OS; T‐stage, N‐stage, and lesion sites are independent factors associated with MFS; and N‐stage, smoking history, and betel quid chewing history are independent factors associated with LRC. A higher CT‐assessed SAT index predicts superior MSF, LCR, and OS in patients with curative HNC, whereas SM does not predict survival or locoregional control.https://doi.org/10.1002/cam4.1365Body mass indexhead and neck cancersubcutaneous adipose tissuesurvival |
| spellingShingle | Ping Ching Pai Chi Cheng Chuang Wen Ching Chuang Ngan Ming Tsang Chen Kan Tseng Kuan Hung Chen Tzu Chen Yen Chien Yu Lin Kai Ping Chang Kin Fong Lei Pretreatment subcutaneous adipose tissue predicts the outcomes of patients with head and neck cancer receiving definitive radiation and chemoradiation in Taiwan Cancer Medicine Body mass index head and neck cancer subcutaneous adipose tissue survival |
| title | Pretreatment subcutaneous adipose tissue predicts the outcomes of patients with head and neck cancer receiving definitive radiation and chemoradiation in Taiwan |
| title_full | Pretreatment subcutaneous adipose tissue predicts the outcomes of patients with head and neck cancer receiving definitive radiation and chemoradiation in Taiwan |
| title_fullStr | Pretreatment subcutaneous adipose tissue predicts the outcomes of patients with head and neck cancer receiving definitive radiation and chemoradiation in Taiwan |
| title_full_unstemmed | Pretreatment subcutaneous adipose tissue predicts the outcomes of patients with head and neck cancer receiving definitive radiation and chemoradiation in Taiwan |
| title_short | Pretreatment subcutaneous adipose tissue predicts the outcomes of patients with head and neck cancer receiving definitive radiation and chemoradiation in Taiwan |
| title_sort | pretreatment subcutaneous adipose tissue predicts the outcomes of patients with head and neck cancer receiving definitive radiation and chemoradiation in taiwan |
| topic | Body mass index head and neck cancer subcutaneous adipose tissue survival |
| url | https://doi.org/10.1002/cam4.1365 |
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