Pretreatment subcutaneous adipose tissue predicts the outcomes of patients with head and neck cancer receiving definitive radiation and chemoradiation in Taiwan.
Ping Ching PaiChi Cheng ChuangWen Ching ChuangNgan-Ming TsangChen Kan TsengKuan Hung ChenTzu Chen YenChien Yu LinKai Ping ChangKin Fong LeiPublished in: Cancer medicine (2018)
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.
Keyphrases
- body composition
- adipose tissue
- body mass index
- computed tomography
- free survival
- resistance training
- bone mineral density
- skeletal muscle
- insulin resistance
- rectal cancer
- end stage renal disease
- image quality
- prognostic factors
- dual energy
- magnetic resonance imaging
- locally advanced
- positron emission tomography
- contrast enhanced
- young adults
- early stage
- high fat diet
- type diabetes
- peritoneal dialysis
- spinal cord
- ejection fraction
- chronic kidney disease
- polycystic ovary syndrome
- lymph node
- metabolic syndrome
- deep learning
- physical activity
- mass spectrometry
- combination therapy
- optical coherence tomography
- radiation induced
- weight loss
- smoking cessation
- spinal cord injury
- atomic force microscopy