Predictors of weight loss during and after radiotherapy in patients with head and neck cancer: A longitudinal study

Purpose: Weight loss is a multifactorial condition that commonly affects patients receiving radiotherapy for head and neck cancers. The aims of this study were to 1) describe body weight changes over time in patients receiving radiotherapy for head and neck cancers and 2) explore the influence of pretreatment weight loss, body mass index (BMI) category, symptom burden, mucositis, and nutritional support on body weight changes over time. Methods: Using a longitudinal design, this study investigated a consecutive cohort of head and neck cancer patients who were treated with radiotherapy between January 2015 to January 2016 in a Taiwan medical center (n = 128). Data regarding symptom burden, mucositis severity, and body weight were collected before radiotherapy (T1), one month after the initial radiotherapy (T2), at the completion of radiotherapy (T3), and one month after the completion of radiotherapy (T4). Results: On average, the participants' body weight decreased by 3.09 kg (SD = 2.79) from T1 to T2, 1.72 kg (SD = 2.06) from T2 to T3, and continued to decrease by 1.04 kg (SD = 2.87) from T3 to T4. The results of a generalized estimating equation showed that BMI category, symptom burden, mucositis, and nutritional support were directly and independently related to body weight changes over time in patients with head and neck cancers. Conclusions: Head and neck cancer patients experience significant weight loss during and after radiotherapy. The study findings are relevant for assessing nutritional status and providing necessary support measures at critical moments for patients treated with radiotherapy.