Body Mass Index and Nutritional Dynamics as Predictors of Survival in Patients with Oropharyngeal Squamous Cell Carcinoma Undergoing Chemoradiation

Background/Objective: Body mass index (BMI) and treatment-related weight variation have been increasingly investigated as potential prognostic factors in head and neck oncology. However, their role in patients with oropharyngeal squamous cell carcinoma (OPSCC) undergoing concomitant chemoradiation (CRT) remains incompletely defined, particularly in real-world Eastern European populations. The aim of this study was to evaluate the prognostic significance of pretreatment BMI and treatment-induced weight variation in patients with OPSCC treated with curative-intent CRT and to assess their association with survival outcomes.

Methods

This single-centre retrospective cohort study evaluated consecutive patients with OPSCC treated with CRT at a Romanian regional oncology centre between 2015 and 2023. Key exclusions were prior surgery or neoadjuvant chemotherapy, palliative care, and secondary malignancies. Clinical variables, baseline comorbidity burden (via Age-Adjusted Charlson Comorbidity Index), and body mass index (BMI) dynamics across treatment timepoints—including pre- and post-CRT BMI, ΔBMI during CRT, and weight loss thresholds ≥5% and ≥10%—were assessed. Overall survival (OS) was analysed using Kaplan–Meier curves, log-rank tests, and Cox proportional hazards multivariate regression to determine independent prognostic factors (p <0.05).