The authors prospectively assessed the independent association between weight loss and deterioration in quality of life (QOL) in patients treated by radiotherapy for head and neck cancer. In 533 head and neck cancer patients treated by curative radiotherapy, changes in weight and QOL were assessed between baseline (before radiotherapy) and follow-up (12 wk after the start of radiotherapy). Patients were categorized into 4 weight loss categories: 0%, 0.1%-5.0%, 5.1%-10.0%, and >10% weight loss. The association between weight loss and change in QOL was analyzed by linear regression analysis, adjusted for sociodemographic and tumor-related characteristics, and additionally for disease specific symptoms and tube feeding. Thirty percent of patients lost 0.1%-5.0% weight, 26% lost 5.1%-10.0% weight, and 24% lost >10% weight. Adjusted regression analyses showed a significant association between weight loss and deterioration of global QOL, physical functioning, social functioning, social eating, and social contact. After additional adjustment for disease-specific symptoms and tube feeding, weight loss (>10%) remained significantly associated with global QOL, social eating, and social contact (P < 0.05). More than 10% weight loss during and directly after radiotherapy has a significant impact on social eating, social contact, and QOL in head and neck cancer patients.

More than 10% weight loss in head and neck cancer patients during radiotherapy is independently associated with deterioration in quality of life

Background
To evaluate the influence of the progonistic nutritional index (PNI) and weight loss on metastasis and long-term mortality in nasopharyngeal carcinoma (NPC).

/pdf/value-of-the-prognostic-nutritional-index-and-weight-loss-in-5ccxybkgds.pdf

Value of the prognostic nutritional index and weight loss in predicting metastasis and long-term mortality in nasopharyngeal carcinoma.

Prediction model to predict critical weight loss in patients with head and neck cancer during (chemo)radiotherapy

Background Head and neck cancer patients are at high risk of weight loss because of their disease process and the treatment of their disease. Recognition of predictors for weight loss may be able to give proactive or reactive nutritional treatment to patients at risk. Objective The aim of this study is to identify the independent risk factors for head and neck cancer patients developing weight loss undergoing radiotherapy. Methods A comprehensive literature search was performed on January 2014. Articles reporting studies of the predictors for weight loss in head and neck cancer patients undergoing radiotherapy were included. These studies were published between 1982 and 2014. Study quality was assessed using a modified quality assessment tool that was designed previously for an observational study. The effects of studies were combined with the study quality score using a best-evidence synthesis model. Results Twenty-two observational studies involving 6159 patients were included. There was strong evidence for 3 predictors, including advanced tumor stage, a higher body mass index before treatment, and the use of concurrent chemoradiotherapy. We also identified 8 moderate evidence predictors and 30 limited evidence predictors. Conclusion The scientific literature to date indicates that patients with advanced tumor stage, or a higher body mass index before treatment, or the use of concurrent chemotherapy are at high risk to have weight loss during radiotherapy. Implications for practice These data provide evidence to guide healthcare professionals in admitting patients who will have weight loss and choosing an optimal prophylactic strategy.

Predictors for Weight Loss in Head and Neck Cancer Patients Undergoing Radiotherapy: A Systematic Review.

Will weight loss cause significant dosimetric changes of target volumes and organs at risk in nasopharyngeal carcinoma treated with intensity-modulated radiation therapy?

The objective of this explorative study was to measure weight loss during radiotherapy and to select predictive factors for early identification of malnourished patients. One hundred and fifty-nine consecutive initial diagnosed nasopharyngeal carcinoma patients attending the Oncology Center at Qilu Hospital of Shandong University, China participated. Patients' weights were measured at the baseline visit and at the end of radiotherapy. The baseline characteristics were recorded. A stepwise linear regression analysis was performed to find association between baseline characteristics and malnutrition. At baseline, 56% of the patients already had a 5% weight loss during the last 3 mo; after the treatment, the median weight loss was 6.9 kg (range, 2.1-12.6 kg). After the multivariate linear regression analyses, the following factors turned out to be independent prognostic factors for significant weight loss: global quality of life, body mass index, N stage, insomnia, radiation techniques, Karnofsky performance status, concurrent chemotherapy, and fatigue. The authors conclude that severe weight loss during radiotherapy for nasopharyngeal carcinoma is common. A combination of clinical factors may lead to malnutrition for nasopharyngeal carcinoma during radiotherapy.

Weight loss during radiotherapy for nasopharyngeal carcinoma: a prospective study from northern China.

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Weight loss during radiotherapy for nasopharyngeal carcinoma: a prospective study from northern China.