Head and neck cancer patients present late cancer cachexia two years after curative chemoradiotherapy.

INTRODUCTION: Over 90% of Head and Neck Cancers are Squamous Cell Carcinoma (HNSCC). HNSCC patients with no evidence of disease after treatment completion usually present a high frequency of late treatment-related toxicities. Here, we aimed to evaluate the prevalence of cachexia among head and neck squamous cell carcinoma patients treated with cisplatin-based chemoradiation with curative intent and presenting no evidence of disease. We hypothesize that even patients post long-term follow-up and curative-intention treatment present a high frequency of cancer cachexia. MATERIALS AND METHODS: This cross-sectional observational study included 120 patients with HNSCC who had previously received definitive or adjuvant chemoradiation. Eligible patients were in regular follow-up for at least 2-years, with no evidence of disease. We assessed clinical characteristics, body composition, muscle strength, nutritional status, and blood tests. The primary outcome was the prevalence of cachexia, and the secondary outcome was an association between cachexia and self-reported dysphagia. RESULTS: Using two different diagnostic criteria (Fearon and Evans criteria), we found that 20.7% and 8.6% of patients presented cancer cachexia after more than two years of follow-up after curative chemoradiation treatment. As expected, cachectic patients presented lower mid-arm muscle circumference, with dysphagia in 73%. In addition, in cachectic patients diagnosed according to Evans's cancer cachexia criteria, we found lower muscle strength levels. There is no association between dysphagia and cancer cachexia, regardless of the diagnostic criteria. CONCLUSION: In long-term follow-up, head and neck squamous cell carcinoma patients with no evidence of disease frequently present with cachexia after curative chemoradiation.