体重减轻对局部晚期头颈部癌放化疗后生存的影响：一项随机 III 期试验（SAKK 10/94）的次要结果。
Impact of weight loss on survival after chemoradiation for locally advanced head and neck cancer: secondary results of a randomized phase III trial (SAKK 10/94).
出版信息
Radiat Oncol. 2015 Jan 17;10:21. doi: 10.1186/s13014-014-0319-y.
BACKGROUND
To analyze the impact of weight loss before and during chemoradiation on survival outcomes in patients with locally advanced head and neck cancer.
METHODS
From 07/1994-07/2000 a total of 224 patients with squamous cell carcinoma of the head and neck were randomized to either hyperfractionated radiation therapy alone or the same radiation therapy combined with two cycles of concomitant cisplatin. The primary endpoint was time to any treatment failure (TTF); secondary endpoints were locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS) and overall survival (OS). Patient weight was measured 6 months before treatment, at treatment start and treatment end.
RESULTS
The proportion of patients with >5% weight loss was 32% before, and 51% during treatment, and the proportion of patients with >10% weight loss was 12% before, and 17% during treatment. After a median follow-up of 9.5 years (range, 0.1 - 15.4 years) weight loss before treatment was associated with decreased TTF, LRRFS, DMFS, cancer specific survival and OS in a multivariable analysis. However, weight loss during treatment was not associated with survival outcomes.
CONCLUSIONS
Weight loss before and during chemoradiation was commonly observed. Weight loss before but not during treatment was associated with worse survival.
背景
分析头颈部局部晚期癌症患者在放化疗前后体重减轻对生存结果的影响。
方法
1994 年 7 月至 2000 年 7 月，共 224 例头颈部鳞状细胞癌患者随机分为单纯超分割放疗组或相同放疗联合顺铂同期化疗 2 周期组。主要终点是任何治疗失败时间（TTF）；次要终点是局部区域无复发生存（LRRFS）、无远处转移生存（DMFS）和总生存（OS）。患者体重在治疗前 6 个月、治疗开始时和治疗结束时测量。
结果
治疗前体重减轻>5%的患者比例为 32%，治疗期间体重减轻>5%的患者比例为 51%，治疗前体重减轻>10%的患者比例为 12%，治疗期间体重减轻>10%的患者比例为 17%。中位随访 9.5 年（范围：0.1-15.4 年）后，多变量分析显示治疗前体重减轻与 TTF、LRRFS、DMFS、癌症特异性生存和 OS 降低相关。然而，治疗期间的体重减轻与生存结果无关。
结论
放化疗前后体重减轻是常见的。治疗前而非治疗期间的体重减轻与生存结果较差相关。
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