Department of Radiation Oncology, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan.
Int J Radiat Oncol Biol Phys. 2012 May 1;83(1):e93-e100. doi: 10.1016/j.ijrobp.2011.11.071. Epub 2012 Feb 17.
To investigate the association of pretreatment body mass index (preT BMI) with outcomes of head-and-neck cancer in patients treated with radiotherapy (RT).
All 1,562 patients diagnosed with head-and-neck cancer and treated with curative-intent RT to a dose of 60 Gy or higher were retrospectively studied. Body weight was measured both at entry and at the end of RT. Cancer-specific survival (CSS), overall survival (OS), locoregional control (LRC), and distant metastasis (DM) were analyzed by preT BMI (<25 kg/m(2) vs. ≥25 kg/m(2)). The median follow-up was 8.6 years.
Patients with lower preT BMI were statistically significantly associated with poorer CSS and OS than those with higher preT BMI. There was no significant difference between preT BMI groups in terms of LRC and DM. Body weight loss (BWL) during radiation did not influence survival outcomes. However, in the group with higher preT BMI, CSS, OS, and DM-free survival of patients with less BWL during radiation were statistically longer when compared with greater BWL.
This study demonstrates that higher preT BMI positively influenced survival outcomes for patients with head-and-neck cancer. Patients with higher preT BMI who were able to maintain their weight during radiation had significantly better survival than patients with greater BWL.
研究头颈部癌症患者放疗前体质量指数（preT BMI）与治疗结局的相关性。
回顾性研究了 1562 名接受根治性剂量为 60Gy 或更高剂量放疗的头颈部癌症患者。在入组时和放疗结束时测量体重。通过 preT BMI（<25kg/m2 与≥25kg/m2）分析癌症特异性生存率（CSS）、总生存率（OS）、局部区域控制率（LRC）和远处转移率（DM）。中位随访时间为 8.6 年。
与 preT BMI 较高的患者相比，preT BMI 较低的患者在 CSS 和 OS 方面明显较差。两组之间在 LRC 和 DM 方面没有显著差异。放疗期间体重减轻（BWL）并不影响生存结局。然而，在 preT BMI 较高的组中，与 BWL 较大的患者相比，放疗期间 BWL 较少的患者 CSS、OS 和无 DM 生存率明显更长。
本研究表明，较高的 preT BMI 对头颈部癌症患者的生存结局有积极影响。能够在放疗期间保持体重的 preT BMI 较高的患者，其生存率明显优于 BWL 较大的患者。
