Impact of weight loss on treatment interruption and unplanned hospital admission in head and neck cancer patients undergoing curative (chemo)-radiotherapy in Hong Kong

Abstract

Abstract Purpose: Malnutrition is of high prevalence in head and neck cancer (HNC) patients with weight loss being one of the major nutrition indicators. The objective of this study is to investigate the impact of weight loss on treatment interruptions and unplanned hospital admissions in HNC patients undergoing radiotherapy with or without chemotherapy. Methods: In this retrospective cohort study, consecutive HNC patients who started (chemo)radiotherapy between January 2011 and December 2019 were included. Body weight was measured before, during and after RT treatment. Factors associated with ≥ 10% weight loss and treatment interruption and unplanned admissions were analyzed using multivariate logistic regression. Results: A total of 1086 subjects with 747(68.8%) nasopharyngeal carcinoma (NPC) and 339(31.2%) non-NPC patients were included. Prevalence of radiotherapy (RT) delay, chemotherapy as planned and cisplatin dose < 200mg/m2 in patients with ≥ 10% vs < 10% weight loss were 6.2% vs 7.0%(p = 0.668), 29.2% vs 31.7%(p = 0.555), 23.8 vs 17.8%(p = 0.127) in NPC patients, and 42.2% vs 50.5%(p = 0.300), 25.6% vs 32.1%(p = 0.464) and 100.0% vs 81.4%(p = 0.245) in non-NPC patients. 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. Conclusion: 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.