Clinical Impact of Cachexia in Unresectable Locally Advanced Head and Neck Cancer: Supplementary Analysis of a Phase II Trial (JCOG0706-S2)

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

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.

Publication types

  • Clinical Trial, Phase II

MeSH terms

  • Aged
  • Cachexia / drug therapy*
  • Cachexia / pathology
  • Female
  • Head and Neck Neoplasms / complications*
  • Head and Neck Neoplasms / pathology
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies