Department of Medical Physics, Hamadan University of Medical Sciences, Hamadan, Iran.
School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
Cancer Treat Res Commun. 2021;26:100281. doi: 10.1016/j.ctarc.2020.100281. Epub 2020 Dec 10.
Side effects of severe weight loss during radiation therapy and its definitive risk factors are the significant complexities of cancer treatment. This study aimed to identify the reliable predictors of severe weight loss during three-dimensional conformal radiation therapy (3D-CRT) in head and neck cancer patients. Weight changes during radiotherapy were investigated on 87 patients. Tumor site, T-stage, BMI, age, smoking, treatment modality, and prior surgery were considered as effective factors. During the 3D-CRT, 78.7% of patients experienced weight loss (p<0.001). The risk of weight loss was higher in patients with cancer in the larynx and oral cavity. Severe weight loss (≥5% during the radiation course) was observed in 47.8% of patients. There was the highest risk of severe weight loss in patients undergoing chemoradiation therapy with previous surgical resection (83.3%). The incidence of severe weight loss in normal-weight patients compared to overweight patients was significant. Severe weight loss was more common at higher doses and in younger patients. BMI regardless of body composition is not a credible predictor. Advanced tumor stage and combined treatment modality in head and neck cancer patients which result in synergizing of treatment toxicities, can be used as the reliable risk factors of severe weight loss during radiotherapy.
放疗期间严重体重减轻的副作用及其明确的危险因素是癌症治疗的显著复杂性。本研究旨在确定头颈部癌症患者三维适形放疗（3D-CRT）期间严重体重减轻的可靠预测因子。对 87 例患者的放疗期间体重变化进行了研究。肿瘤部位、T 分期、BMI、年龄、吸烟、治疗方式和先前手术被认为是有效因素。在 3D-CRT 期间，78.7%的患者出现体重减轻（p<0.001）。喉和口腔癌患者体重减轻的风险更高。47.8%的患者出现严重体重减轻（放疗过程中体重减轻≥5%）。先前手术切除后接受放化疗的患者发生严重体重减轻的风险最高（83.3%）。与超重患者相比，正常体重患者发生严重体重减轻的发生率显著更高。严重体重减轻更常见于高剂量和年轻患者。无论身体成分如何，BMI 都不是一个可信的预测因子。晚期肿瘤分期和头颈部癌症患者的联合治疗方式导致治疗毒性协同作用，可作为放疗期间严重体重减轻的可靠危险因素。
