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MO_34_2782 - Effect of Neoadjuvant Chemotherapy Followed by Concurrent Chemoradiotherapy on Nutritional Status in Locoregionally Advanced Nasopharyngeal Carcinoma Patients: A Prospective Observational Study

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Effect of Neoadjuvant Chemotherapy Followed by Concurrent Chemoradiotherapy on Nutritional Status in Locoregionally Advanced Nasopharyngeal Carcinoma Patients: A Prospective Observational Study
J. Miao1, C. Hu2, S. Lin3, X. Chen4, Y. Chen5, Y. Zhong6, F. Jin7, Q. Lin8, X. Hu9, N. Zhang10, R. Wang11, L. Wang12, C. Wang13, M. Zhu13, H. Wu13, M. Di13, Y. Huang13, C. Xie6, and C. Zhao14; 1Sun Yat-Sen University Cancer Center, Guangzhou, China, 2Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China, 3Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University, Fuzhou, China, 4Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, China, 5Department of Radiation Oncology, Zhejiang Cancer Hospital, Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, China, 6Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China, 7Guizhou Medical University, Guiyang, China, 8The Fist Affiliated Hospital of Xiamen University, Xiamen, China, 9The First People's Hospital of Foshan, Guangzhou, China, 10The First People’s Hospital of Foshan, Guangzhou, China, 11Guangxi tumor radiation therapy clinical medical research center, nanning, China, 12Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China, 13Sun Yat-sen University Cancer Center, Guangzhou, China, 14Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China

Purpose/Objective(s): The purpose of this study was to investigate the influence of neoadjuvant chemotherapy (NACT) combined with concurrent chemoradiotherapy (CCRT) on nutritional status in patients with locoregionally advanced nasopharyngeal carcinoma (LANPC).

Materials/Methods: This is a prospective, non-interventional, multicenter study. Patients were recruited from ten hospitals in China with the key inclusion criteria of untreated LANPC. All eligible patients received NACT with docetaxel (75mg/m2) and cisplatin (75mg/m2) once every 3 weeks for 2 cycles, followed by CCRT with cisplatin (100mg/m2) and intensity-modulated radiotherapy. Nutrition related parameters including weight loss (WL), body mass index (BMI), the score of Nutrition Risk Screening 2002 (NRS2002) and Patient-Generated Subjective Global Assessment (PG-SGA), and Quality of life (QoL) score (EORTC QLQ-C30), acute toxicities (CTCAE v4.0), treatment compliance were recorded before, during, and after treatment. Statistical analyses are using SPSS 22.0. The study was registered on ClinicalTrials.gov, number NCT02575547.

Results: From Jun 2015 to Nov 2016, we enrolled 186 patients, of whom 171 were eligible for analysis. The overall incidence of mild and severe malnutrition was 68.5% and 37.4%, respectively. The incidence of nutritional related parameters and the average QoL score on each observation point were shown in Table 1. During the treatment, patients with ≥ 2 grade oral mucositis have higher risks of WL ≥ 10% (P = 0.037), NRS2002 ≥ 3 points (P = 0.002) and PG-SGA ≥ 9 points (P < 0.001). 97.7% and 87.7% patients finished NACT and CCRT, respectively, and 99.4% patients finished radiotherapy. Patients with PG-SGA ≥ 9 points and C30-QoL < 50 points had poor chemotherapy compliance (P = 0.014 and P < 0.001), and patients with BMI < 18.5 had poor radiotherapy compliance (P = 0.036).

Conclusion: Malnutrition was prevalent in LANPC patients treated with NACT plus CCRT, and mainly occurred in CCRT period, even lasted until 1 year after treatment in some patients. Furthermore, its impact on clinical outcomes need long-term follow-up. Table 1 Incidence of nutrition related parameters and the average quality of life score on each observation points
prior NACT after 1 cycle NACT prior RT 4th week of RT end of RT 3 months after RT 1 year after RT
WL ≥ 5% (mild malnutrition) 5.3% 6.0% 5.4% 38.7% 68.5% 64.1% 54.1%
WL ≥ 10% (severe malnutrition) 0 1.8% 1.8% 7.7% 33.3% 37.4% 28.4%
BMI < 18.5 5.8% 7.1% 6.5% 12.5% 19.4% 16.8% 13.5%
NRS2002 ≥ 3 points (high risk of malnutrition) 8.2% - 6.9% 54.4% 79.4% 10.9% 6.7%
PG-SGA ≥ 4 points (need nutrition treatment) 16.8% - 23.6% 96.7% 96.6% 38.3% 12.2%
PG-SGA ≥ 9 points (need nutrition treatment urgently) 3.0% - 3.9% 72.0% 76.6% 6.3% 0
C30-QoL score 73.65 - 71.82 50.76 48.49 71.03 76.64

Author Disclosure: J. Miao: None. C. Hu: None. S. Lin: None. Y. Zhong: None.

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MO_34_2782 - Effect of Neoadjuvant Chemotherapy Followed by Concurrent Chemoradiotherapy on Nutritional Status in Locoregionally Advanced Nasopharyngeal Carcinoma Patients: A Prospective Observational Study



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