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

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Abstract

Purpose

Malnutrition is highly prevalent in head and neck cancer (HNC) patients, with weight loss being one of the major nutritional indicators. The objective of this study was to investigate the impact of weight loss on treatment interruptions and unplanned hospital admissions in HNC patients undergoing radiotherapy (RT) with or without chemotherapy.

Methods

In this retrospective cohort study, consecutive HNC patients who started RT between January 2011 and December 2019 were included. Data from a total of 1086 subjects with 747 (68.8%) nasopharyngeal carcinomas (NPCs) and 31.2% (N=339) non-NPC patients were analysed. Body weight (BW) was measured before, during, and after RT treatment. Factors associated with ≥10% weight loss, treatment interruption, and unplanned admissions were analysed using multivariate logistic regression.

Results

The prevalence of ≥10% weight loss was 26.8% (N=288), with 32.7% (N=243) in NPC and 13.5% (N=45) in non-NPC patients. The prevalence of RT delay in patients with ≥10% vs. <10% weight loss was 6.2% vs. 7.0% (p=0.668) in NPC patients and 42.2% vs. 50.5% (p=0.300) in non-NPC patients. The 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. Clinical implications: With the knowledge of the impact of weight loss on hospital admissions and the characteristics of patients with weight loss, nutritional intervention can be effectively focused on the stratification of patients for intensive nutritional support to reduce weight loss.

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Acknowledgements

Special thanks to Uta Schmidt-Straßburger for formatting and editing the original work, Jamie Chan for English language editing, Kenny Tse and Jeffery Lee for chemotherapy information, and Queenie Yuen and Ringo Sin for clerical support.

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Authors and Affiliations

  1. Department of Dietetics, Tuen Mun Hospital, Hong Kong, China

    Ying-Chu Choi

  2. Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, China

    Po-Chung Chan, Ka-Wai Alice Cheung & Kwok-Leung Aray Wong

  3. Quality and Services Department, Tuen Mun Hospital, Hong Kong, China

    Jia-Jie Huang

  4. Department of Otolaryngology, Augsburg University Hospital, Augsburg, Germany

    Johannes Doescher

  5. Department of Clinical Oncology, University of Hong Kong, Hong Kong, China

    Tai-Chung Lam

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Contributions

CYC, TCL, PCC, and KWC contributed to the study conception and design. CYC and KLW participated in data collection and writing. CYC, JJH, and TCL participated in data analyses. CYC, JJH, JD, and TCL participated in data interpretation. CYC, KWC, PCC, JD, and TCL were involved in writing, reviewing, and editing the manuscript. TCL and JD provided supervision. The first draft of the manuscript was written by CYC, and all authors reviewed the manuscript and gave final approval for publication.

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Correspondence to Ying-Chu Choi.

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Appendix

Appendix

Table 6 Prevalence of weight loss at the end of RT treatment in patients with treatment interruptions and unplanned admission
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Choi, YC., Chan, PC., Cheung, KW. et al. Impact of weight loss on treatment interruption and unplanned hospital admission in head and neck cancer patients undergoing curative (chemo)-radiotherapy in Hong Kong. Support Care Cancer 31, 487 (2023). https://doi.org/10.1007/s00520-023-07952-8

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  • DOI: https://doi.org/10.1007/s00520-023-07952-8

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