Background
Methods
Study cohort
Data collection
Treatment
Follow-up and end points
Statistical analysis
Results
Demographic, patterns of treatment failure, and survival
Determination of cutoff points for weight loss and the distribution of patients characteristics in the entire patient cohort
Characteristics | Non-critical weight loss (N = 1056) | Critical weight loss (N = 1343) |
P
|
---|---|---|---|
Age (y) media (range) | 45 (13–78) | 46 (13–78) | 0.004 |
Gender (%) | |||
Male | 817 (77.4) | 1009 (75.1) | 0.202 |
Female | 239 (22.6) | 334 (24.9) | |
Clinical stage (%) | |||
I-II | 476 (45.1) | 489 (36.4) | <0.001 |
III-IV | 580 (54.9) | 854 (63.6) | |
T-stage (%) | |||
T1-2 | 648 (61.4) | 745 (55.5) | 0.004 |
T3-4 | 408 (38.6) | 598 (44.5) | |
N-stage (%) | |||
N0-1 | 744 (70.5) | 841 (62.6) | <0.001 |
N2-3 | 312 (29.5) | 502 (37.4) | |
Treatment group (%) | |||
RT | 547 (51.8) | 519 (38.6) | <0.001 |
CRT | 509 (48.2) | 824 (61.4) | |
Smoking status (%) | |||
never-smokers | 552 (52.3) | 697 (51.9) | 0.856 |
ex-smokers | 504 (47.7) | 646 (48.1) | |
RT dose (Gy), media (range) | 70 (60–87) | 70 (60–86) | 0.127 |
BMI (kg/m2), media (range) | 22.04 (14.04–35.36) | 22.77 (13.61–39.06) | <0.001 |
Impact of critical weight loss on survival in the entire patient
OS | FFS | LR-FFS | D-FFS | |||||
---|---|---|---|---|---|---|---|---|
HR (95 % CI) |
P
| HR (95 % CI) |
P
| HR (95 % CI) |
P
| HR (95 % CI) |
P
| |
Patient cohort (n = 2399) | ||||||||
Unadjusted model | 1.411 (1.214–1.639) | <0.001 | 1.383 (1.193–1.603) | <0.001 | 1.487 (1.248–1.771) | <0.001 | 0.941 (0.688–1.287) | 0.702 |
Adjusted model | 1.352 (1.160–1.576) | <0.001 | 3.275 (1.101–9.740) | 0.033 | 6.620 (2.990–14.658) | <0.001 | 1.432 (0.149–13.736) | 0.755 |
Subset I (n = 1374) | ||||||||
Matched/Unadjusted model | 1.554 (1.259–1.917) | <0.001 | 1.539 1.251–1.895) | <0.001 | 1.577 (1.241–2.004) | <0.001 | 1.276 (0.763–2.134) | 0.352 |
Matched/Adjusted model | 1.515 (1.227–1.871) | <0.001 | 1.504 (1.221–1.852) | <0.001 | 9.395 (2.965–29.765) | <0.001 | 0.846 (0.02–36.683) | 0.931 |
Subset II (n = 110) | ||||||||
Matched/Unadjusted model | 4.857 (1.049–22.483) | 0.043 | 4.857 (1.049–22.483) | 0.043 | 5.143 (0.601–44.027) | 0.135 | 2.037 (0.185–22.470) | 0.560 |
Matched/Adjusted model | 4.998 (1.080–23.141) | 0.040 | 4.986 (1.077–23.086) | 0.040 | 5.356 (0.623–46.011) | 0.126 | 1.656 (0.144–19.117) | 0.680 |
Impact of critical weight loss on survival in the patients received concurrent chemoradiotherapy or radiotherapy alone
Before Matching | After Matching | |||||
---|---|---|---|---|---|---|
Characteristics | Non-CWL (N = 687) | CWL (N = 869) |
P
| Non-CWL (N = 687) | CWL (N = 687) |
P
|
Age (y) media (range) | 45 (13–78) | 47 (14–77) | 0.005 | 45 (13–78) | 46 (15–77) | 0.050 |
Sex (%) | ||||||
Male | 522 (76.0) | 657 (75.6) | 0.863 | 522 (76.0) | 518 (75.4) | 0.801 |
Female | 165 (24.0) | 212 (24.4) | 165 (24.0) | 169 (24.6) | ||
Clinical stage (%) | ||||||
I-II | 388 (56.5) | 381 (43.8) | <0.001 | 388 (56.5) | 352 (51.2) | 0.051 |
III–IV | 299 (43.5) | 488 (56.2) | 299 (43.5) | 335 (48.8) | ||
T-stage (%) | ||||||
T1-2 | 481 (70.0) | 529 (60.9) | <0.001 | 481 (70.0) | 458 (66.7) | 0.182 |
T3-4 | 206 (30.0) | 340 (39.1) | 206 (30.0) | 229 (33.3) | ||
N-stage (%) | ||||||
N0-1 | 536 (78.0) | 592 (68.1) | <0.001 | 536 (78.0) | 521 (75.8) | 0.337 |
N2-3 | 151 (22.0) | 277 (31.9) | 151 (22.0) | 166 (24.2) | ||
Treatment group (%) | ||||||
RT | 547 (79.6) | 519 (59.7) | <0.001 | 547 (79.6) | 509 (74.1) | 0.015 |
CRT | 140 (20.4) | 350 (40.3) | 140 (20.4) | 178 (25.9) | ||
Smoking status (%) | ||||||
never-smokers | 375 (54.6) | 450 (51.8) | 0.272 | 375 (54.6) | 365 (53.1) | 0.588 |
ex-smokers | 312 (45.4) | 419 (48.2) | 312 (45.4) | 322 (46.9) | ||
RT dose (Gy), media (range) | 70 (60–87) | 70 (60–86) | 0.081 | 70 (60–87) | 70 (60–86) | 0.599 |
BMI (kg/m2) media (range) | 22.05 (14.04–34.89) | 22.83 (15.35–39.06) | <0.001 | 22.05 (14.04–34.89) | 22.41 (15.35–32.99) | 0.058 |
Impact of critical weight loss on survival in IMRT cohort
Before Matching | After Matching | |||||
---|---|---|---|---|---|---|
Characteristics | Non-CWL (N = 55) | CWL (N = 83) |
P
| Non-CWL (N = 55) | CWL (N = 55) |
P
|
Age (y) media (range) | 41 (18–60) | 42 (13–73) | 0.538 | 41 (18–60) | 40 (15–67) | 0.832 |
Sex (%) | ||||||
Male | 39 (70.9) | 63 (75.9) | 0.513 | 39 (70.9) | 41 (74.5) | 0.669 |
Female | 16 (29.1) | 20 (24.1) | 16 (29.1) | 14 (25.5) | ||
Clinical stage (%) | ||||||
I-II | 24 (43.6) | 20 (24.1) | 0.016 | 24 (43.6) | 19 (34.5) | 0.329 |
III-IV | 31 (56.4) | 63 (75.9) | 31 (56.4) | 36 (65.5) | ||
T-stage (%) | ||||||
T1-2 | 30 (54.5) | 36 (43.4) | 0.198 | 30 (54.5) | 24 (43.6) | 0.252 |
T3-4 | 25 (45.5) | 47 (56.6) | 25 (45.5) | 31 (56.4) | ||
N-stage (%) | ||||||
N0-1 | 44 (80.0) | 40 (48.2) | <0.001 | 44 (80.0) | 38 (69.1) | 0.189 |
N2-3 | 11 (20.0) | 43 (51.8) | 11 (20.0) | 17 (30.9) | ||
Treatment group (%) | ||||||
RT | 34 (61.8) | 24 (28.9) | <0.001 | 34 (61.8) | 23 (41.8) | 0.036 |
CRT | 21 (38.2) | 59 (71.1) | 21 (38.2) | 32 (58.2) | ||
Smoking status (%) | ||||||
Never-smokers | 33 (60.0) | 48 (57.8) | 0.800 | 33 (60.0) | 31 (56.4) | 0.699 |
Ex-smokers | 22 (40.0) | 35 (42.2) | 22 (40.0) | 24 (43.6) | ||
RTdose (Gy), media (range) | 68 (66–81) | 68 (66–68) | 0.289 | 68 (66–81) | 68 (66–88) | 0.254 |
BMI (kg/m2), media (range) | 23.34 (14.86–30.08) | 23.23 (15.35–30.82) | 0.565 | 23.34 (14.86–30.08) | 23.23 (15.35–30.82) | 0.268 |