Weight loss in patients with head and neck cancer during and after conventional and accelerated radiotherapy

Figures & data

Table I. Characteristics for use of tube feeding (TF) at the start and the end of radiotherapy (RT) (n = 712).

	Start RT, n (%)				End RT, n (%)
Characteristics	Use of TF	No TF	P*	Missing	Use of TF	No TF	P*	Missing
Age
< 65 years ≥ 65 years	36 (8.2) 40 (14.9)	403 (91.8) 228 (85.1)	0.006	5	200 (48.0) 135 (53.6)	217 (52.0) 117 (46.4)	0.175	43
Sex
Male Female	60 (11.4) 16 (8.8)	465 (88.6) 166 (91.2)	0.405	5	249 (50.3) 86 (49.4)	246 (49.7) 88 (50.6)	0.860	43
Site
Oropharynx Larynx Hypopharynx Oral cavity	23 (6.7) 11 (7.4) 30 (25.4) 12 (12.6)	322 (93.3) 138 (92.6) 88 (74.6) 83 (87.4)	< 0.001	5	161 (48.8) 53 (38.4) 75 (66.4) 46 (52.3)	169 (51.2) 85 (61.6) 38 (33.6) 42 (47.7)	< 0.001	43
Clinical stage
I II III IV	1 (3.3) 5 (5.4) 17 (8.7) 53 (13.6)	29 (96.7) 87 (94.6) 178 (91.3) 337 (86.4)	0.041	5	13 (43.3) 37 (41.1) 89 (48.4) 196 (53.7)	17 (56.7) 53 (58.9) 95 (51.6) 169 (46.3)	0.134	43
Treatment modality
CF AF	35 (9.8) 41 (11.7)	322 (90.2) 309 (88.3)	0.467	5	126 (38.3) 209 (61.5)	203 (61.7) 131 (38.5)	< 0.001	43
BMI^‡
Underweight Normal weight Overweight/obese	8 (18.2) 13 (9.3) 5 (2.9)	36 (81.8) 127 (90.7) 170 (97.1)	0.001	353	25 (62.5) 60 (45.1) 67 (40.1)	15 (37.5) 73 (54.9) 100 (59.9)	0.041	372
Karnofsky
< 80  ≥ 80	19 (33.3) 50 (8.1)	38 (66.7) 565 (91.9)	< 0.001	40	–^†	–^†	–^†	–^†
Swallowing problem
Yes No	52 (53.1) 24 (3.9)	46 (46.9) 585 (96.1)	< 0.001	5	322 (62.8) 11 (7.1)	191 (37.2) 143 (92.9)	< 0.001	45
Mucositis
Yes No	–^†	–^†	–^†	–^†	295 (51.7) 30 (35.7)	276 (48.3) 54 (64.3)	0.007	57
Use of opioid analgesics
Yes No	29 (39.2) 47 (7.4)	45 (60.8) 584 (92.6)	< 0.001	7	217 (66.8) 116 (34.0)	108 (33.2) 225 (66.0)	< 0.001	46
Number of patients, n (%)	76 (10.7)	631 (88.6)		5 (0.7%)	335 (47.1)	334 (46.9)		43 (6.0)

*p-value controlled by Fisher's Exact Test; ^†Data not recorded at that time point; ^‡ Underweight: BMI < 20 (BMI < 22 if ≥ 70 years); normal weight: BMI 20–25 (BMI 22–27 if ≥ 70years); overweight/obese: BMI > 25 (BMI > 27 if ≥ 70 years).

Table II. Characteristics for weight loss during the acute phase (n = 432). Weight change percent at five months after the end of radiotherapy (RT) is shown in relation to initial weight taken at the start of RT (mean [SD]).

	Acute phase Weight change (%), mean [SD]
Characteristics	All	P*	Missing
Weight change total	−11.3 [8.6]
Age
< 65 years ≥ 65 years	−12.0 [8.1] −10.1 [9.3]	0.032	−
Sex
Male Female	−11.6 [8.5] −10.7 [8.9]	0.371	−
Site
Oropharynx Larynx Hypopharynx Oral cavity	−13.7 [7.9] −8.6 [7.7] −8.4 [9.8] −9.0 [8.9]	< 0.001^‡ 0.002^§	−
Clinical stage
I II III IV	−11.8 [6.5] −10.0 [8.2] −10.2 [8.0] −12.4 [8.6]	0.088 – 0.999^‖	−
BMI^†
Underweight Normal weight Overweight/ obese	−3.5 [9.1] −9.3 [7.5] −14.5 [7.3]	< 0.001^¶ 0.003**	178
Treatment modality
CF AF	−11.3 [8.1] −11.4 [9.0]	0.839	−
Surgery
Yes No	−12.1 [8.0] −10.9 [9.0]	0.150	−
Karnofsky start
< 80  ≥ 80	−5.9 [10.3] −11.6 [8.4]	0.002	21
Swallowing problems start RT
Yes No	−7.1 [10.4] −11.7 [8.3]	0.003	1
Swallowing problems end RT
Yes No	−11.9 [8.8] −10.1 [7.9]	0.076	14
Mucositis end RT
Yes No	−12.0 [8.3] −6.6 [9.3]	< 0.001	21
Use of opioid analgesics start RT
Yes No	−10.4 [10.7] −11.4 [8.4]	0.547	3
Use of opioid analgesics end RT
Yes No	−12.1 [8.6] −10.8 [8.6]	0.118	15
Tube feeding start RT
Yes No	−5.7 [11.0] −11.8 [8.3]	< 0.001	4
Tube feeding end RT
Yes No	−10.8 [9.2] −11.9 [8.1]	0.212	17

*p-value controlled by Independent samples T-test or One way ANOVA; ^† Underweight: BMI < 20 (BMI < 22 if ≥ 70 years); normal weight: BMI 20–25 (BMI 22–27 if ≥ 70years); overweight/obese: BMI > 25 (BMI > 27 if ≥ 70 years); ^‡ p-value when comparing tumor of the oropharynx against tumors of the larynx and hypopharynx; ^§ p-value when comparing tumor of the oropharynx against tumor of the oral cavity; ^‖ no significant values for weight change, range p-values (min, max); ^¶ p-value when comparing BMI overweight/obese with BMI underweight and BMI normal weight; **p-value when comparing BMI underweight with BMI normal weight.

Figure 1. Weight change in % (mean ± 95% CI) from the start of RT up to different time points during and after the termination of RT (n = 175). The data are presented in total and divided by patients receiving conventional fractionation (CF, n = 79) and accelerated fractionation (AF, n = 96).