• 5/21/2008
  • Charleston, SC
  • Theodore R McRackan et al.
  • Laryngoscope, May 9, 2008

Objective:
To investigate the association between initial body mass index (BMI) and chemoradiation therapy (CRT) outcomes in head and neck cancer patients.

Methods::
Retrospective study of 72 patients with American Joint Committee on Cancer stage III or IV squamous cell carcinoma of the oropharynx, hypopharynx, or larynx treated with primary concurrent CRT with curative intent over a 5 year period. Logistic and Cox regression analyses were used to determine the association between initial BMI and percutaneous endoscopic gastrostomy tube dependence, tumor recurrence, disease-free survival, and overall survival while controlling for the independent variables of age, sex, race, site, stage, and smoking and alcohol use.

Results:
Patients with normal or low BMI (BMI


Conclusion:
The present study suggests that CRT patients with BMI greater than 25 have improved swallowing outcomes, longer time to disease recurrence, and improved survival when compared with similar patients with lower BMI. BMI at presentation may be an important clinical factor to consider when determining the optimal treatment modality for a head and neck cancer patient. Further investigation is required to determine whether primary surgery should be the preferred treatment in normal or low BMI patients.

Authors:
Theodore R McRackan, John M Watkins, Amy E Herrin, Elizabeth M Garrett-Mayer, Anand K Sharma, Terry A Day, and M Boyd Gillespie

Authors’ affiliations:
From the Department of Otolaryngology?Head and Neck Surgery (t.r.m., t.a.d., m.b.g.), the Department of Radiation Oncology (j.m.w., a.k.s.), and the Department of Biostatistics, Bioinformatics, and Epidemiology (a.e.h., e.g.m.), Medical University of South Carolina, Charleston, South Carolina, U.S.A