Low Serum Albumin, Body Mass Index, and Feeding Route Predict Treatment Interruptions During Concurrent Chemoradiotherapy in Head and Neck Cancer: A Retrospective Cohort Study
- 1Prince of Songkla University
Abstract
Objective To identify nutrition‐related predictors of treatment interruption during concurrent chemoradiotherapy (CCRT), the primary outcome and to determine the secondary impact of interruption on 5‐year overall survival (OS). Methods This retrospective cohort study analyzed 440 head and neck cancer (HNC) patients receiving definitive CCRT (January 2013 to December 2016) at a tertiary academic center. Treatment interruption was defined as radiotherapy total treatment time > 56 days or cumulative delay > 7 days, and as chemotherapy delay > 7 days or premature discontinuation. Multivariable logistic regression identified independent predictors; Kaplan–Meier analysis compared 5‐year OS by interruption status and tumor site. Results Among 440 patients (mean age 55 years; 81.7% male), 52.3% experienced chemotherapy interruptions and 14.4% radiotherapy interruptions. Independent nutritional predictors of chemotherapy interruption were: serum albumin < 3.5 g/dL (adjusted OR 2.54, 95% CI 1.19–5.43, p = 0.016), pretreatment BMI category (overall p = 0.032, driven mainly by a protective trend for BMI > 25 kg/m2 [adjusted OR 0.55, 95% CI 0.30–1.00, p = 0.051]; the < 18.5 kg/m2 subgroup showed a nonsignificant increase in risk: adjusted OR 1.41, 95% CI 0.84–2.35, p = 0.196), and oral feeding (vs. feeding tube as reference) (adjusted OR 2.27, 95% CI 1.07–4.76, p = 0.030). In non‐nasopharyngeal cancer, radiotherapy interruption significantly reduced 5‐year OS (14.3% vs. 29.9%, p = 0.03). Chemotherapy interruptions did not significantly affect survival. Conclusions Hypoalbuminemia (< 3.5 g/dL), pretreatment BMI category, and feeding route independently predict chemotherapy interruptions in HNC. Radiotherapy interruptions significantly impair survival in non‐nasopharyngeal cancers. These readily available markers should guide pretreatment nutritional optimization and feeding tube consideration in high‐risk patients.
Related
- Sequential chemoradiotherapy vs. radiotherapy alone or concurrent chemoradiotherapy after radical resection of stage IA2–IIA1 cervical cancer: a retrospective cohort study
- Psychosocial Distress and Radiation Treatment Interruptions in Patients With Cancer Using Machine Learning and Regression: Retrospective Cohort Study.
- A Systematic Review and Meta-Analysis: Does Molecular Hydrogen Exert Radioprotective Effects Without Compromising the Antitumor Efficacy of Radiotherapy or Concurrent Chemoradiotherapy?
- Comparative Evaluation of Concurrent Carboplatin-Paclitaxel Versus Cisplatin-Etoposide Chemoradiotherapy in Unresectable Non-small Cell Lung Cancer: A Prospective Randomized Study
- Prediction Model for Detecting Active Pulmonary Tuberculosis in Patients With Head and Neck Cancer Prior to Concurrent Chemoradiotherapy
BibTeX
@article{jantharapattana2026serum,
title = {{Low Serum Albumin, Body Mass Index, and Feeding Route Predict Treatment Interruptions During Concurrent Chemoradiotherapy in Head and Neck Cancer: A Retrospective Cohort Study}},
author = {Kitti Jantharapattana and Nattarin Nilrat},
journal = {Laryngoscope investigative otolaryngology},
year = {2026},
month = oct,
doi = {10.1002/lio2.70595},
url = {https://europepmc.org/article/PMC/PMC13657857},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Low Serum Albumin, Body Mass Index, and Feeding Route Predict Treatment Interruptions During Concurrent Chemoradiotherapy in Head and Neck Cancer: A Retrospective Cohort Study
AU - Kitti Jantharapattana
AU - Nattarin Nilrat
PY - 2026
DA - 2026/10/01
JO - Laryngoscope investigative otolaryngology
DO - 10.1002/lio2.70595
UR - https://europepmc.org/article/PMC/PMC13657857
AB - Objective To identify nutrition‐related predictors of treatment interruption during concurrent chemoradiotherapy (CCRT), the primary outcome and to determine the secondary impact of interruption on 5‐year overall survival (OS). Methods This retrospective cohort study analyzed 440 head and neck cancer (HNC) patients receiving definitive CCRT (January 2013 to December 2016) at a tertiary academic center. Treatment interruption was defined as radiotherapy total treatment time > 56 days or cumulative delay > 7 days, and as chemotherapy delay > 7 days or premature discontinuation. Multivariable logistic regression identified independent predictors; Kaplan–Meier analysis compared 5‐year OS by interruption status and tumor site. Results Among 440 patients (mean age 55 years; 81.7% male), 52.3% experienced chemotherapy interruptions and 14.4% radiotherapy interruptions. Independent nutritional predictors of chemotherapy interruption were: serum albumin < 3.5 g/dL (adjusted OR 2.54, 95% CI 1.19–5.43, p = 0.016), pretreatment BMI category (overall p = 0.032, driven mainly by a protective trend for BMI > 25 kg/m2 [adjusted OR 0.55, 95% CI 0.30–1.00, p = 0.051]; the < 18.5 kg/m2 subgroup showed a nonsignificant increase in risk: adjusted OR 1.41, 95% CI 0.84–2.35, p = 0.196), and oral feeding (vs. feeding tube as reference) (adjusted OR 2.27, 95% CI 1.07–4.76, p = 0.030). In non‐nasopharyngeal cancer, radiotherapy interruption significantly reduced 5‐year OS (14.3% vs. 29.9%, p = 0.03). Chemotherapy interruptions did not significantly affect survival. Conclusions Hypoalbuminemia (< 3.5 g/dL), pretreatment BMI category, and feeding route independently predict chemotherapy interruptions in HNC. Radiotherapy interruptions significantly impair survival in non‐nasopharyngeal cancers. These readily available markers should guide pretreatment nutritional optimization and feeding tube consideration in high‐risk patients.
SN - 2378-8038
ER -