Predictors of Weight Loss during Conformal Radiotherapy for Head and Neck Cancers – How Important are Planning Target Volumes?

Exploration of risk factors for weight loss in head and neck cancer patients

“…24,25 In this study mean weight loss was similar, although at the top end of the range reported in other studies 20,21,24 (Table 3). A total of 60% (24) patients had severe weight loss (>5%), which is higher than that reported at the end of radiotherapy in other studies 20,22 ; 15% (six) patients lost >10% body weight throughout radiotherapy, fewer than the 74·2% reported by Munshi et al, 26 but similar to Mallick et al 22 and Langius et al 20 Final weight measurements were taken during the last week of radiotherapy (in some cases earlier if final week data were not available). Mallick et al 22 studied up to 1 month postradiotherapy; 52 out of 103 patients had data for this time point.…”

“…A total of 60% (24) patients had severe weight loss (>5%), which is higher than that reported at the end of radiotherapy in other studies 20,22 ; 15% (six) patients lost >10% body weight throughout radiotherapy, fewer than the 74·2% reported by Munshi et al, 26 but similar to Mallick et al 22 and Langius et al 20 Final weight measurements were taken during the last week of radiotherapy (in some cases earlier if final week data were not available). Mallick et al 22 studied up to 1 month postradiotherapy; 52 out of 103 patients had data for this time point. Mean weight loss was higher than at the end of radiotherapy (4·1 versus 3·8%) but rates of weight loss >5% were similar (36·5 versus 37·9%).…”

“…This audit found nodal status to be predictive of weight loss, while Mallick et al 22 found that larger PTVs were predictive. In the study by Langius et al 20 irradiation of neck nodes was the most reliable factor for predicting significant weight loss.…”

“…Previous studies have found chemoradiotherapy and radiotherapy doses >60 Gy were both associated with increased weight loss. 22,26 Concurrent chemotherapy and higher doses of radiotherapy are known to increase toxicity, potentially leading to dysphagia, reducing capacity for oral intake. 29 The associated risk of weight loss is therefore understandable.…”

“…20 considers unintentional weight loss >5% during a course of radiotherapy as risking malnutrition, as have others 21,22 ;t h e r e f o r e ,t h e same value has been applied within this work.…”