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Impact of weight loss in patients with head and neck carcinoma undergoing radiotherapy: is it an underestimated phenomenon? A radiation oncologist’s perspective

European Journal of Clinical Nutrition volume 69, pages 757–760 (2015)Cite this article

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Nutrition is a crucial topic in oncology, a worsening in nutritional status being able to influence both the course of the disease and its outcome. Malnutrition is a pathological state characterized by an inadequate intake of energy and/or nutrients to meet the biological needs of the body, leading to a systemic catabolic state with potentially reversible changes in body composition and function.1 Weight loss, one of the most characteristic signs of malnutrition, is a common finding in patients with head and neck (HN) cancer and is associated with poor prognosis.2, 3 During radiotherapy (RT) and chemoradiotherapy, the percentage of malnourished patients rises to 44–88%.3 Moreover, critical weight loss (>5% from the start of RT until week 8 or >7.5% until week 12)4 in HN patients may be seen in as high as 57% of patients.1 Therefore, there is a need to assess the role of nutritional support in the comprehensive management of these patients. Here we briefly outline the current lack of consensus on this issue and why more high-quality studies are required.

First, we would like to emphasize the impact of weight loss on patients’ quality of life. In general, the overall quality of life depends on both physical and psychological well-being, and patients who lose excessive weight develop functional limitations, cognitive alterations and emotional stress. Currently, there is evidence that nutritional support in the form of dietary recommendations and supplementary oral nutrition can improve patients’ quality of life and enhance recovery from adverse effects of RT.2, 5 Indeed, it should be the norm that randomized controlled trials include quality-of-life measures, preferably through patient-reported outcome assessments.6 This should encompass a comprehensive evaluation of patients’ perceptions of symptoms, functioning and general well-being, regardless of other crude oncological end points. It should be highlighted that minimizing patient weight loss is a key issue. Its relevance extends beyond the goals of improving patients’ quality of life and preventing problems of malnutrition-related changes in body composition and function.

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Author information

Authors and Affiliations

  1. Radiation Oncology Department, Cruces University Hospital, Barakaldo, Spain

    J Cacicedo

  2. BioCruces Health Research Institute, Barakaldo, Spain

    J Cacicedo

  3. Radiation Oncology Department, Bern University Hospital, Bern, Switzerland

    A Dal Pra

  4. Radiation Oncology Department, Sacro Cuore-Don Calabria Hospital, Negrar, Italy

    F Alongi

  5. Radiation Oncology Department, Hospital Duran i Reynals (ICO), Barcelona, Spain

    A Navarro

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Correspondence to J Cacicedo.

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Cacicedo, J., Dal Pra, A., Alongi, F. et al. Impact of weight loss in patients with head and neck carcinoma undergoing radiotherapy: is it an underestimated phenomenon? A radiation oncologist’s perspective. Eur J Clin Nutr 69, 757–760 (2015). https://doi.org/10.1038/ejcn.2015.65

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