ESTRO 2024 - Abstract Book

S1453

Clinical - Head & neck

ESTRO 2024

Purpose/Objective:

Sarcopenia has emerged as a critical factor influencing the prognosis and risk of complications in cancer patients. This study seeks to comprehensively assess the effects of sarcopenia on both survival and functional outcomes in a group of patients with head and neck squamous cell carcinoma (HNSCC) who received definitive (chemo)radiotherapy ((C)RT) as their primary treatment.

Material/Methods:

The study enrolled patients diagnosed with HNSCC who underwent definitive (C)RT between January 2022 and June 2023. To determine sarcopenia, measurements were taken from computed tomography (CT) scans during radiation planning, focusing on the skeletal muscles at level C3. We used the Kaplan-Meier method to evaluate the impact of sarcopenia on overall survival (OS). In addition, multivariable association models were developed to investigate sarcopenia's influence on functional outcomes.

Results:

The study included a total of 70 HNSCC patients. The cutoff values for diagnosing sarcopenia were established as skeletal muscle index (SMI) values below 42 cm2/m2 for men and 30 cm2/m2 for women, corresponding to the lowest gender-specific quartile. Notably, patients with sarcopenia exhibited significantly poorer survival rates, particularly those with lower performance status (p < 0.0001). Among patients with oropharyngeal cancer, it was observed that survival was more influenced by the p16 status than by the presence of sarcopenia (p = 0.8302). In multivariable association models, sarcopenia was found to be correlated with an increased incidence of acute dysphagia (p = 0.05). However, it did not show significant associations with the development of late dysphagia, trismus, or the need for speech therapy six months post-treatment (p = 0.99, p = 0.91, p = 0.55, respectively).

Conclusion:

In the context of HNSCC patients undergoing definitive (C)RT, sarcopenia represents an independent prognostic factor associated with unfavorable survival outcomes. Additionally, it is linked to a higher incidence of acute dysphagia of greater severity. The results of this study underscore the significance of early recognition and management of sarcopenia in the care and treatment of HNSCC patients, especially those with lower performance status, as it may have a considerable impact on their overall survival and quality of life. This research highlights the multifaceted nature of factors affecting the prognosis and functional outcomes of HNSCC patients undergoing (C)RT and suggests that tailored treatment strategies may be necessary based on individual patient characteristics.

Keywords: sarcopenia, radiotheraphy, functional outcomes