Weight loss during Radiation Therapy in Patients of Head & Neck (H&N) Cancer

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Radiation Oncology
Head and Neck Cancers
Presenter SUBHADIP Das
Citation Annals of Oncology (2018) 29 (suppl_9): ix94-ix104. 10.1093/annonc/mdy438
Authors S. Das1, D. Lahiri1, S. Mandal2, P. Biswas1
  • 1Department Of Radiotherapy, Chittaranja National Cancer Institute, 700026 - Kolkata/IN
  • 2Epidemiology & Biostatistics, Chittaranja National Cancer Institute, 700026 - Kolkata/IN

Abstract

Background

Head & neck cancer patients treated with radical/adjuvant radiotherapy suffer from weight loss, the cause of which can be multifactorial. In this study we have evaluated weight loss pattern in H&N cancer patients receiving either conventional or conformal chemoradiotherapy (CCRT)/adjuvant radiotherapy (RT) and to find out possible factors.

Methods

A retrospective study was done using data of already treated head & neck cancer patients. Inclusion criteria- 1) Primary site: oral cavity, oropharynx, larynx, & hypopharynx. 2) Treated with either radical CCRT(with Inj. Cisplatin) or adjuvant RT. Exclusion criteria- 1) palliative radiotherapy, 2)treatment gap >6 days. Basic parameters were collected, weight at beginning & at end of Radiotherapy noted. As general rule, Ryle’s tube insertion was done only when needed (difficulty to swallow liquid).

Results

160 patients’ data were collected: 80 patients- Conformal RT (40 patients radical CCRT & 40 patients adjuvant RT), 80 patients- Conventional RT (40 patients radical CCRT & 40 patients adjuvant RT). Only 5 patients (2 conformal CCRT & 3 conformal RT) out of total 160 patients gained weight during course of RT. Hence, 155 patients suffered weight loss. We compared variables with absolute weight loss of ≤ 5kg & >5kg using Chi square (χ2) test. Also, variables were compared with relative weight loss of ≤ 10% & >10%. The variables affecting both absolute and relative weight loss were initial low KPS status, use of conventional RT technique and use of chemotherapy & higher radiation dose (>60Gy). It was also found that ryle’s tube insertion was significantly more in patients with >5kg/>10% weight loss.Table: 312P

Variables affecting absolute and relative weight loss: χ2 Assessment (P Value) (* indicates significant)

Variables≤ 5kg vs. >5kg (n = 118) (n = 37)≤10% vs. >10% (n = 94) (n = 61)
Gender (male vs. female)0.5080.801
Age (≤50 years vs. >50 years)0.6440.421
KPS (<80 vs. ≥80)<0.001*<0.001*
Site(Oral Cavity vs. Oropharynx vs. Larynx&Hypopharynx)0.5460.413
Indication & Dose (Radical CCRT- 66Gy vs. Adjuvant RT- 60Gy)0.005*0.038*
RT Technique (Conventional vs. Conformal)0.009*0.001*

Conclusions

Weight loss in H&N cancer patients during CCRT/RT is expected. Conformal RT (which corresponds to reduced treatment volume & toxicities), better KPS status can limit the extent of weight loss. Addition of chemotherapy and higher radiation dose (>60Gy) will increase weight loss. Ryle’s tube insertion as prophylaxis may be considered, specially in patients with expected weight loss >5kg/>10%.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Subhadip Das, Debarshi Lahiri, Syamsundar Mandal, Priyanka Biswas.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.