Prevalence of Cachexia After Curative Cisplatin-Based Concurrent Chemoradiation in Head and Neck Cancers
Abstract PurposeWe determine the frequency of cachexia among head and neck squamous cell carcinoma patients treated with cisplatin-based chemoradiation with curative intent and presenting no evidence of disease. MethodsConsecutive patients were included from January 2014 to February 2017. Participants were over 18 y.o. and diagnosed with head and neck squamous cell carcinomas previously treated with definitive or adjuvant chemoradiation. Eligible patients were in regular follow-up for at least 2 years, with no evidence of disease. Body weight, height, mid-arm muscle circumference, muscle strength, and nutritional status were measured, and blood tests were obtained. The main outcome was the presence of cachexia, and self-reported dysphagia. Results120 patients were included, 73% were male, and age was 59 y.o. (range, 21–78). The most common primary site was oropharynx (42%). Median follow-up was 42 mo. (range, 24–125 mo.). Most patients presented locally advanced disease at diagnosis: 73% T3-T4 and 72% N+. Dysphagia was a major complaint (73%). Cachexia was diagnosed in 23 (20.7%) and 10 (8.6%) patients according to Fearon and Evans criteria, respectively. Cachectic patients presented lower mid-arm muscle circumference (p < 0.05). In addition, lower muscle strength levels (p<0.05) were found among cachectic patients according to Evans criteria, and there was an association between the presence of dysphagia and the diagnosis of cachexia. ConclusionsHead and neck squamous cell carcinoma patients with no evidence of disease frequently present cachexia after chemoradiation in a long-term follow-up. More effective preventive and therapeutic strategies for cachexia are required in this scenario.