Explorative study on the predictive value of systematic inflammatory and metabolic markers on weight loss in head and neck cancer patients undergoing radiotherapy

AbstractIntroductionHead and neck cancer patients receiving radiotherapy can experience a number of toxicities, including weight loss and malnutrition, which can impact upon the quality of treatment. The purpose of this retrospective cohort study is to evaluate weight loss and identify predictive factors for this patient group.Materials and methodsA total of 40 patients treated with radiotherapy since 2012 at the study centre were selected for analysis. Data were collected from patient records. The association between potential risk factors and weight loss was investigated.ResultsMean weight loss was 5 kg (6%). In all, 24 patients lost >5% starting body weight. Age, T-stage, N-stage, chemotherapy and starting body weight were individually associated with significant differences in weight loss. On multiple linear regression analysis age and nodal status were predictive.ConclusionYounger patients and those with nodal disease were most at risk of weight loss. Other studies have identified the same risk factors along with several other variables. The relative significance of each along with a number of other potential factors is yet to be fully understood. Further research is required to help identify patients most at risk of weight loss; and assess interventions aimed at preventing weight loss and malnutrition.

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The impact of weight loss on setup accuracy for head and neck cancer patients in the era of image guided radiation therapy

Journal of Radiation Oncology ◽

10.1007/s13566-016-0274-3 ◽

2016 ◽

Vol 5 (4) ◽

pp. 359-362 ◽

Cited By ~ 1

Author(s):

Sayyad Y. Zia ◽

William Smith ◽

Umut Ozbek ◽

Awais Mirza ◽

Rendi Sheu ◽

...

Keyword(s):

Weight Loss ◽

Radiation Therapy ◽

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Image Guided Radiation Therapy ◽

Image Guided ◽

Setup Accuracy ◽

The Impact

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P.81 Weight loss increases postoperative morbidity and length of hospital stay in head and neck cancer patients

Clinical Nutrition ◽

10.1016/s0261-5614(95)80230-4 ◽

1995 ◽

Vol 14 ◽

pp. 56

Author(s):

M.A.E. van Bokhorst-de van der Schueren ◽

J.J. Quak ◽

H.P. Sauerwein ◽

R.I.C. Wesdorp ◽

G.B. Snow ◽

...

Keyword(s):

Weight Loss ◽

Head And Neck Cancer ◽

Hospital Stay ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Postoperative Morbidity ◽

Length Of Hospital Stay

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Overall Neutrophil-to-Lymphocyte Ratio and SUVmax of Nodal Metastases Predict Outcome in Head and Neck Cancer Before Chemoradiation

Frontiers in Oncology ◽

10.3389/fonc.2021.679287 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jonas Werner ◽

Klaus Strobel ◽

Dirk Lehnick ◽

Gunesh P. Rajan

Keyword(s):

Head And Neck Cancer ◽

Lymph Node ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Primary Tumor ◽

Nodal Metastases ◽

Metabolic Markers ◽

Node Metastases ◽

Fdg Pet Ct

IntroductionThis study investigates the pretherapeutic neutrophil-to-lymphocyte ratio (NLR) with markers of tumor metabolism in 18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and their potential prognostic value in head and neck cancer patients prior to primary chemoradiation.Materials and MethodsNLR and metabolic markers of primary tumor and nodal metastases including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were retrospectively assessed in a consecutive cohort of head and neck squamous cell cancer patients undergoing primary chemoradiation. The main outcome measure was survival.ResultsThe study included 90 patients of which 74 had lymph node metastases at diagnosis. Median follow-up time of nodal positive patients (n=74) was 26.5 months (IQR 18–44). The NLR correlated significantly with metabolic markers of the primary tumor (TLG: rs=0.47, P<0.001; MTV: rs=0.40, P<0.001; SUVmax: rs=0.34, P=0.003), but much less with FDG-PET/CT surrogate markers of metabolic activity in nodal metastases (TLG: rs=0.15, P=0.19; MTV: rs=0.25, P=0.034; SUVmax: rs=0.06, P=0.63). For nodal positive cancer patients, multivariate analysis showed that an increased NLR (HR=1.19, 95% CI=1.04-1.37, P=0.012) and SUVmax of lymph node metastasis (HR=1.09; 95% CI=0.99-1.19; P=0.081) are independently predictive of disease-specific survival. High NLR had a negative prognostic value for overall survival (HR=1.16, 95% CI=1.02-1.33, P=0.021).ConclusionNLR correlates positively with metabolic markers of the primary tumor, suggestive of an unspecific inflammatory response in the host as a possible reflection of increased metabolism of the primary tumor. SUVmax of lymph node metastases and the NLR, however, show no correlation and are independently predictive of disease-specific survival. Therefore, their addition could be used to improve survival prediction in nodal positive head and neck cancer patients undergoing primary chemoradiation.

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