Severe weight loss during, but not before, simultaneous chemotherapy and radiation therapy for stage III and IV squamous cell carcinoma of the head and neck (SCCHN) is associated with increased survival

Background: Severe weight loss commonly occurs before and during chemo-irradiation for Stage III and IV SCCHN. Nevertheless, the effects of severe weight loss on short and long term outcomes are unknown. Objective: To evaluate effects of pre-treatment weight loss versus weight loss during chemotherapy/radiation for advanced operable SCCHN on toxicity, tumor response, recurrent tumor and survival. Methods: Records of 52 patients with Stage III and IV, clinically operable SCCHN who underwent primary high-dose radiotherapy and concomitant chemotherapy (cisplatin, 20mg/M2/four consecutive days during weeks 1, 4, and 7 of radiotherapy) (CTRT) were examined retrospectively in two groups: 7.5% weight loss (SEVERE; n=41). Data included tumor site, grade, stage, pre-CTRT weight loss, CTRT toxicity, response (CCR = Clinical Complete; HCR = Histologic Complete without residual tumor), surgeries, recurrence, and overall and disease-free survival. Statistical analysis: Chi-square, ANOVA, and Kaplan-Meier. Results: Per study design, weight loss was greater in the SEVERE group versus NON-SEVERE (-17.3% +- 7.9% versus -2.9% +- 4.2%, p