Clinical determinants of weight loss in patients receiving radiation and chemoirradiation for head and neck cancer: a prospective longitudinal view.
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.
Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. ckubrak@ualberta.ca
Catherine
C
Kubrak
Kärin
K
Olson
Naresh
N
Jha
Rufus
R
Scrimger
Matthew
M
Parliament
Linda
L
McCargar
Sheryl
S
Koski
Vickie E
VE
Baracos
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D016190:Carboplatin / Q000008:administration & dosage; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology; D006258:Head and Neck Neoplasms / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D009752:Nutritional Status; D011446:Prospective Studies; D011788:Quality of Life; D011879:Radiotherapy Dosage; D015431:Weight Loss
D002097:C-Reactive Protein; D016190:Carboplatin; D002945:Cisplatin