Clinical determinants of weight loss in patients with esophageal carcinoma during radiotherapy: a prospective longitudinal view.
OBJECTIVE
The prevalence of weight loss in esophageal carcinoma patients is high and associated with impairment of physical function, increased psychological distress and low quality of life. It is not known which factors may contribute to weight loss in patients with esophageal carcinoma during radiotherapy in China. The objective of this study was to identify the associated demographic and clinical factors influencing weight loss.


METHODS
We evaluated 159 esophageal carcinoma patients between August 2010 and August 2013 in a cross- sectional, descriptive study. Patient characteristics, tumor and treatment details, psychological status, adverse effects, and dietary intake were evaluated at baseline and during radiotherapy. A multivariate logistic regression analyss was performed to identify the potential factors leading to weight loss.


RESULTS
64 (40.3%) patients had weight loss ≥ 5% during radiotherapy. According to logistic regression analysis, depression, esophagitis, and loss of appetite were adverse factors linked to weight loss. Dietary counseling, early stage disease and total energy intake ≥ 1,441.3 (kcal/d) were protective factors.


CONCLUSIONS
It was found that dietary counseling, TNM stage, total energy intake, depression, esophagitis, and loss of appetite were the most important factors for weight loss. The results underline the importance of maintaining energy intake and providing dietary advice in EC patients during RT. At the same time, by identifying associated factors, medical staff can provide appropriate medical care to reduce weight loss. Further studies should determine the effect of these factors on weight loss and propose a predictive model.
School of Nursing, Tianjin Medical University, China E-mail : yuezhaotjmedu@163.com.
Nan
N
Jiang
Jin-Zhi
JZ
Zhao
Xiao-Cen
XC
Chen
Li-Ya
LY
Li
Li-Juan
LJ
Zhang
Yue
Y
Zhao
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000503:physiopathology*; D002681:China; D003430:Cross-Sectional Studies; D002149:Energy Intake / Q000502:physiology; D004938:Esophageal Neoplasms / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011446:Prospective Studies; D011788:Quality of Life; D015431:Weight Loss / Q000502:physiology*