Influence of weight loss on outcomes in patients with head and neck cancer undergoing concomitant chemoradiotherapy.

Background. The purpose of this study was to determine the influence of weight loss on outcome in patients with head and neck cancer undergoing concomitant chemora- diotherapy (CCRT): treatment interruption, infections, mortality, and hospital readmission rate. Methods. Forty patients with head and neck cancer were en- rolled. All patients were counseled to follow a nutritional program during CCRT. Body weight was evaluated at baseline, at the end, and 30 days after radiochemotherapy. Results. Ninety percent of compliant patients with nutritional program maintained body weight (mean, 1 6 2.4 kg) and 100% of noncompliant patients continued to lose weight (mean, 29 6 4k g; p < .001). A reduction greater than 20% of prediagnosis weight significantly correlated with treatment interruption (p 5 .003), infec- tions (p 5 .002), early mortality (p 5 .011), hospital readmission rate (p 5 .001), and survival (log-rank test: z 52 2.722, p 5 .006). Conclusion. In patients with head and neck cancer under- going CCRT, the early nutritional management reduces weight loss and improve outcome. V C 2007 Wiley Periodicals, Inc. Head Neck 30: 503-508, 2008