Investigators reported that patients with head and neck cancer who had an overweight body mass index (BMI) may have had better outcomes, longer overall and progression-free survival, and lower rates of locoregional failure than those patients with a normal or obese BMI, according to a recent study published by Sung Jun Ma, MD, a resident physician in the Department of Radiation Medicine at Roswell Park Comprehensive Cancer Center, Buffalo, New York, and colleagues, in JAMA Network Open.1 The new findings shed light on how BMI may impact treatment response, risk of recurrence, and survival in patients with head and neck cancer.
Sung Jun Ma, MD
Study Methods and Results
BMI scores fall into four categories: underweight (BMI of < 18.5 kg/m2); normal weight (BMI between 18.5 and 24.9 kg/m2); overweight (BMI between 25.0 and 29.9 kg/m2); and obese (BMI of ≥ 30.0 kg/m2). Both overweight and obesity are associated with high blood pressure, type 2 diabetes, coronary heart disease, stroke, and an increased risk of several types of cancer. It is estimated that by 2030, nearly 50% of all U.S. adults will fall into the obese BMI range.
In the recent study, the investigators analyzed the overall and progression-free survival rates of 445 patients with nonmetastatic head and neck cancer who were treated with chemoradiotherapy from 2005 to 2021—107 of whom had a normal BMI, 179 of whom had an overweight BMI, and 159 of whom had and obese BMI. Because only a small number of eligible patients had underweight or were treated with surgery or radiation therapy alone, the investigators excluded them from the study.
Positron-emission tomography–computed tomography imaging after treatment revealed that complete metabolic responses were higher in patients with an overweight BMI (91.6%) vs those with a normal BMI (73.8%) and were also higher in patients with an obese BMI (90.6%) vs those with a normal BMI (73.8%). Further, patients with overweight had a 5-year overall survival rate of 71.5%, a 5-year progression-free survival rate of 68.3%, and a locoregional failure rate of 7.0% vs 58.4%, 50.8%, and 25.9%, respectively, for those with a normal BMI.
DISCLOSURE: For full disclosures of the study authors, visit jamanetwork.com.
1. Ma SJ, Khan M, Chatterjee U, et al: Association of body mass index with outcomes among patients with head and neck cancer treated with chemoradiotherapy. JAMA Netw Open 6:e2320513, 2023.