weight loss during chemoradiotherapy in patients with nasopharyngeal cancers
Purpose/Objective
Concurrent chemo-radiotherapy (CCR) is currently the gold standard treatment for nasopharyngeal carcinoma (NPC). The objective of this retrospective study is to analyze the variations in weight observed in patients with nasopharyngeal cancers under concurrent chemo-radiotherapy, in order to optimize dietary care.
Material/Methods
240 patients with nasopharyngeal cancers, treated in the Radiotherapy department at the National Oncology Institute in Rabat between January 1st, 2018 and December 30, 2021 by curative concurrent chemo-radiotherapy, using the VMAT (Volumetric Modulated Arc Therapy) technique delivering 70 Gy in 33 fractions, with chemotherapy based on cisplatin (40mg / m2 / week) with an average of 5 cures.
Variations in weight were collected at the beginning, the mid, and the end of treatment.
Results
From the beginning to the end of treatment, it can be seen that 85% of patients lost weight (median = 6,05 kg [1,5kg- 13,6kg]), according to a separate distribution: 33% had lost more than 8 kg, 56% had lost between 3 and 8 kg, and only 11% had lost less than 3 kg.
Weight loss from mid to end of treatment (median = 3, 55 kg [1 kg−8,1kg]) was greater than that from baseline to mid-treatment (median = 2,5 kg [0,5 kg−5,5kg]) (P = 0.016).
For the rest of patients (15%) : 7% had kept a stable weight, and 8% gained an average of 2 to 6 kg.
Conclusion
Three-quarters of patients receiving concurrent chemo-radiotherapy lost weight during treatment, despite weekly adverse reaction monitoring.
Early nutrition intervention with dietary advice associated with oral nutritional supplementation is necessary in order to favorably influence the outcome of patients by limiting weight loss.
