Original Research Article
Year: 2019 | Month: June | Volume: 6 | Issue: 6 | Pages: 6-10
Evaluation of Treatment Related Weight Loss in Patients with Head and Neck Cancers Undergoing Radiotherapy
Dr Siddharth Vats1, Dr Rohit Mahajan2, Dr Manoj Gupta1, Dr Rajeev K Seam2, Dr Manish Gupta1
1Department of Radiotherapy and Oncology, Indira Gandhi Medical College (IGMC) Shimla, Himachal Pradesh, India
2Department of Radiotherapy and Oncology, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Mullana, Ambala, Haryana, India
Corresponding Author: Dr Rohit Mahajan
ABSTRACT
Purpose: Weight loss is common among patients with squamous cell carcinoma of the head and neck during chemo-radiotherapy and may be due to multiple tumor and treatment related factors. The aim of the present study was to evaluate factors associated with weight loss during radiotherapy treatment of head and neck cancers.
Methods: One hundred one patients of squamous cell carcinoma of head and neck treated with concurrent chemoradiation or postoperative radiotherapy were evaluated in this analysis. Major head and neck subsites including Oropharynx, Oral cavity Hypopharynx and Nasopharynx were included in the analysis. A dose of 66-70Gy was given in the radical chemoradiation schedule. In postoperative radiotherapy, a dose of 60-64Gy was delivered. Patients were treated with two-field or three field conventional radiation techniques. Patient’s weight was evaluated before, weekly during treatment and after completion of treatment to evaluate weight loss trends. Weight loss grading was done as per CTCAE v3.
Results: Analysis was done to see which factors were causative in patients having a grade 1(5-10%) and grade 2(>10%) weight loss. Three variables were found to be significant for >5% weight loss. These were a tumor located in base of tongue (p < 0.007), use of chemoradiation (p<0.013), and a total dose of > 60 Gy (p<0.012). Other factors like trismus (p<0.063) and xerostomia (p<0.060) also showed trend towards significance. No difference was observed in patients with weekly or 3 weekly chemo-radiation schedules.
Conclusion: Our study shows that base of tongue cancers on chemoradiation had significant weight loss compared to other head and neck subsites. Radiation doses over 60 Gy is another significant factor for weight loss.
Key words: Head neck cancers, Weight loss, Radiotherapy.
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