Factors associated with weight loss during radiotherapy in patients with stage I or II head and neck cancer

Background The purpose of the study was to identify factors associated with weight loss during radiotherapy (RT) in patients with stage I or II head and neck (HN) cancer. Methods This study was conducted as part of a phase III chemoprevention trial. A total of 540 patients were randomized. The patients were weighed before and after RT. Patients' characteristics, dietary intake, health-related quality of life (HRQOL), tumor characteristic, treatment characteristics, and acute adverse effects of RT were evaluated at baseline and during RT. Factors independently associated with weight loss during RT were identified using the multiple linear regression (P <= 0.05). Results The mean weight loss during RT was 2.2 kg (standard deviation, 3.4). In bivariate analyses, the occurrence of adverse effects of RT and most of the HRQOL dimensions evaluated during RT were correlated with weight loss. In the multivariate analysis, eight factors were associated with a greater weight loss: all HN cancer sites other than the glottic larynx (P<0.001), TNM stage II disease (P=0.01), higher pre-RT body weight (P<0.001), dysphagia before RT (P<0.005), higher mucosa adverse effect of RT (P=0.03), lower dietary energy intake during RT (P<0.001), lower score of the digestive dimension on the Head and Neck Radiotherapy Questionnaire (P<0.001) and a higher score of the constipation symptom on the EORTC QLQ-C30 during RT (P=0.02). Conclusions The results underline the importance of maintaining energy intake in early stage HN cancer patients during RT and the importance of preventing and treating adverse effects.