Department of Dietetics, Tuen Mun Hospital, Hong Kong, China.
Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, China.
Support Care Cancer. 2023 Jul 24;31(8):487. doi: 10.1007/s00520-023-07952-8.
Malnutrition is highly prevalent in head and neck cancer (HNC) patients, with weight loss being one of the major nutritional indicators. The objective of this study was to investigate the impact of weight loss on treatment interruptions and unplanned hospital admissions in HNC patients undergoing radiotherapy (RT) with or without chemotherapy.
In this retrospective cohort study, consecutive HNC patients who started RT between January 2011 and December 2019 were included. Data from a total of 1086 subjects with 747 (68.8%) nasopharyngeal carcinomas (NPCs) and 31.2% (N=339) non-NPC patients were analysed. Body weight (BW) was measured before, during, and after RT treatment. Factors associated with ≥10% weight loss, treatment interruption, and unplanned admissions were analysed using multivariate logistic regression.
The prevalence of ≥10% weight loss was 26.8% (N=288), with 32.7% (N=243) in NPC and 13.5% (N=45) in non-NPC patients. The prevalence of RT delay in patients with ≥10% vs. <10% weight loss was 6.2% vs. 7.0% (p=0.668) in NPC patients and 42.2% vs. 50.5% (p=0.300) in non-NPC patients. The prevalence of unplanned admissions in patients with ≥10% vs. <10% weight loss was 51.9% vs. 25.3% (p<0.001) in NPC patients and 68.9% vs. 27.0% (p<0.001) in non-NPC patients.
In our study, ≥10% weight loss was found to be associated with a higher rate of unplanned admissions but not with RT delay or chemotherapy interruption.
With the knowledge of the impact of weight loss on hospital admissions and the characteristics of patients with weight loss, nutritional intervention can be effectively focused on the stratification of patients for intensive nutritional support to reduce weight loss.
营养不良在头颈部癌症（HNC）患者中非常普遍，体重减轻是主要营养指标之一。本研究的目的是调查体重减轻对接受放化疗或不放化疗的 HNC 患者放疗中断和非计划性住院的影响。
在这项回顾性队列研究中，纳入了 2011 年 1 月至 2019 年 12 月期间开始接受放疗的连续 HNC 患者。共分析了 1086 名患者的数据，其中 747 名（68.8%）为鼻咽癌（NPC）患者，31.2%（N=339）为非 NPC 患者。在放疗治疗前后测量体重（BW）。使用多变量逻辑回归分析与≥10%体重减轻、治疗中断和非计划性入院相关的因素。
≥10%体重减轻的发生率为 26.8%（N=288），NPC 患者为 32.7%（N=243），非 NPC 患者为 13.5%（N=45）。与<10%体重减轻的患者相比，≥10%体重减轻的患者中 RT 延迟的发生率分别为 NPC 患者的 6.2%和 7.0%（p=0.668），非 NPC 患者的 42.2%和 50.5%（p=0.300）。与<10%体重减轻的患者相比，≥10%体重减轻的患者中无计划入院的发生率分别为 NPC 患者的 51.9%和 25.3%（p<0.001），非 NPC 患者的 68.9%和 27.0%（p<0.001）。
在我们的研究中，发现≥10%的体重减轻与更高的非计划性入院率相关，但与 RT 延迟或化疗中断无关。
了解体重减轻对住院的影响以及体重减轻患者的特征，可以有效地将营养干预重点放在患者分层上，以进行强化营养支持，减少体重减轻。
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