Jackson William, Alexander Neil, Schipper Matthew, Fig Lorraine, Feng Felix, Jolly Shruti
Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
Head Neck. 2014 Sep;36(9):1356-62. doi: 10.1002/hed.23461. Epub 2013 Nov 21.
Patients with head and neck cancer experience significant weight loss secondary to concurrent chemoradiotherapy (CCRT). Using dual-energy X-ray absorptiometry (DEXA) scans, we characterize total body composition changes during and after CCRT in order to develop novel clinical care models that will improve the patient's quality of life (QOL).
Sixty DEXA scans were obtained from 12 patients undergoing CCRT for locally advanced squamous cell head and neck cancer. DEXAs were performed at baseline, during treatment, completion of CCRT, and then 1 and 2 months posttreatment.
Mean weight loss by treatment end was 9.5 kg (10.2%; p = .0002). On average, lean body mass (LBM) decreased 10.2% (p = .001), and fat body mass (FBM) decreased 11.1% (p = .001) during CCRT. LBM began to normalize after completion of treatment, whereas FBM continued to decline.
Substantial loss of muscle and FBM occurs in patients undergoing CCRT for head and neck cancer. To prevent long-term disability and QOL decline after curative CCRT, clinical care interventions incorporating aggressive nutrition/exercise counseling are needed.
头颈部癌患者在同步放化疗（CCRT）期间会出现明显体重减轻。我们使用双能X线吸收法（DEXA）扫描来描述CCRT期间及之后的全身成分变化，以开发能够改善患者生活质量（QOL）的新型临床护理模式。
从12例接受CCRT治疗局部晚期头颈部鳞状细胞癌的患者中获取了60次DEXA扫描结果。在基线、治疗期间、CCRT结束时以及治疗后1个月和2个月进行DEXA扫描。
到治疗结束时，平均体重减轻9.5千克（10.2%；p = 0.0002）。在CCRT期间，瘦体重（LBM）平均下降10.2%（p = 0.001），脂肪体重（FBM）下降11.1%（p = 0.001）。治疗结束后LBM开始恢复正常，而FBM继续下降。
接受CCRT治疗的头颈部癌患者会出现大量肌肉和FBM流失。为防止根治性CCRT后出现长期残疾和QOL下降，需要采取包含积极营养/运动咨询的临床护理干预措施。
