Format

Send to

Choose Destination
Jpn J Clin Oncol. 2019 Jan 1;49(1):37-41. doi: 10.1093/jjco/hyy145.

Clinical impact of cachexia in unresectable locally advanced head and neck cancer: supplementary analysis of a phase II trial (JCOG0706-S2).

Author information

1
Department of Otolaryngology, Fukushima Medical University Hospital, Fukushima, Japan.
2
Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan.
3
Kobe University Hospital Cancer Center, Kobe, Japan.
4
Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan.
5
Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
6
Department of Otolaryngology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
7
Asahi University Hospital, Department of Head and Neck Surgery and Otolaryngology, Gifu, Japan.
8
Department of Head and Neck Surgery, Aichi Cancer Center, Nagoya, Japan.
9
Department of Head and Neck Surgery, Hyogo Cancer Center, Akashi, Japan.
10
Department of Head and Neck Surgery, Shikoku Cancer Center, Matsuyama, Japan.
11
Division of Head and Neck Surgery, Miyagi Cancer Center, Natori, Japan.
12
Division of Clinical Oncology, Shizuoka Cancer Center, Shizuoka, Japan.
13
Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
14
Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan.

Abstract

Objectives:

To evaluate the clinical impact of cachexia, defined by the combination of albumin and C-reactive protein levels, in patients with unresectable locally advanced head and neck squamous cell carcinomas who received chemoradiotherapy in a phase II trial of JCOG0706.

Methods:

Forty-five patients received radiation for a total of 70 Gy/35fr concurrently with S-1 and cisplatin. The present analysis was conducted in 44 patients with available data. The association between treatment efficacy and cachexia was investigated. Pretreatment cachexia was defined as a serum albumin level of less than 3.5 mg/dl and C-reactive protein level of more than 0.5 mg/dl.

Results:

Among the 44 patients, 5 patients had cachexia. On comparison with the cachexic and non-cachexic patients, the percentage of clinical complete remission (20% vs 72%), time to treatment failure at 3 years, (20% vs 53%) and proportion of treatment completion (20% vs 79%) were statistically worse in the cachexic patients, while overall survival, progression-free survival and local progression-free survival at 3 years tended to be worse in cachexic patients.

Conclusions:

This supplementary analysis from a prospective study suggests that a pretreatment status of cancer cachexia is a prognostic factor for treatment outcomes and compliance in patients with locally advanced head and neck squamous cell carcinomas treated with chemoradiotherapy, and a candidate stratification factor in future prospective trials in this population.

PMID:
30364985
DOI:
10.1093/jjco/hyy145
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center