Clinical determinants of weight loss in patients receiving radiation and chemoirradiation for head and neck cancer: a prospective longitudinal view

Head Neck. 2013 May;35(5):695-703. doi: 10.1002/hed.23023. Epub 2012 Jun 22.

Abstract

Background: We aimed to determine the effects of systemic inflammation and symptoms of head and neck cancer patients on dietary intake and weight in relation to mode of treatment.

Methods: In all, 38 orally fed patients had intake, weight, C-reactive protein (CRP), and symptoms prospectively assessed at baseline, post-treatment, and follow-up.

Results: Intake/weight declined and CRP increased substantially in chemoirradiation patients (-11.4 ± 5.2 kg, -1214 kcal/day, 23.4 ± 24.9 mg/L; p < .05) versus radiotherapy patients (-3.5 ± 4.8 kg, -483 kcal/day, 8.3 ± 13.9 mg/L) during posttreatment (repeated-measures ANOVA). Multivariate generalized estimating equations modeling identified reduced swallowing capacity was a key predictor of energy intake in both treatment groups (p < .001); multiple symptoms experienced by radiotherapy/chemoirradiation patients were significant predictors of weight loss; additionally, in chemoirradiation patients, CRP was an independent predictor of weight loss (p < .001).

Conclusions: Treatment of symptoms and systemic inflammation are important clinical targets to manage weight loss in patients with head and neck cancer, especially those treated with chemoirradiation.

MeSH terms

  • Adult
  • Aged
  • C-Reactive Protein / analysis
  • Carboplatin / administration & dosage
  • Chemoradiotherapy*
  • Cisplatin / administration & dosage
  • Deglutition Disorders / etiology
  • Deglutition Disorders / physiopathology
  • Head and Neck Neoplasms / complications
  • Head and Neck Neoplasms / physiopathology
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Middle Aged
  • Nutritional Status
  • Prospective Studies
  • Quality of Life
  • Radiotherapy Dosage
  • Weight Loss*

Substances

  • C-Reactive Protein
  • Carboplatin
  • Cisplatin