2. to explore the influence of mucositis and nutritional support on weight change over time.
Methods: The study uses a longitudinal design. A convenient sample of 101 H&NC patients scheduled for RT was recruited from a medical center in Taiwan. Data on patients’ demographics and clinical variables were collected prior to RT. Body weight and mucositis were measured repeatedly at baseline (T1), one month (T2), the completion of radiotherapy (T3), and one month after completing radiotherapy (T4).
The mean age of the sample was 54.3 (SD=10.8). Majority of the patients were male (n = 87), married (n = 80), and had a middle school (n = 30) education level. Thirty-seven patients had oral cancer, 29 had nasopharyngeal cancer, 23 had oropharynx cancer, and 12 had pharynx cancer. Their cancer stages were 11 in stage I or II, 23 in stage III, and 67 in stage IV. The average body weight was 69.4 Kg (SD = 13.2) at T1, 66.3 (SD = 12.0) at T2, 64.5 (SD = 11.9) at T3, and 63.4 (SD =10.7) at T4. Results of GEE showed a significant time effect [F =2802.6, P<.001] on body weight. As for the parameter estimates, the patients’ body weight dropped from the baseline by 5.96 kg at T4, 4.82 kg at T3, and 3.09 kg at T2. Results of GEE also showed a significant main effect of mucositis and interaction effects of nutritional support by time on body weight after controlling for the patients’ height, age, and the dose of radiation. Patients with a higher grade of mucositis had a lower body weight. The changes of body weight over time were significantly different among patients with different types of nutritional support. Those who had oral intake during the entire course of RT or had enteral tube feeding part-way through the course of RT had more weight loss than those who received enteral tube feeding during the course of RT.
The results of the study supported that H&NC patients are at a great risk for body weight loss while receiving RT, especially for those with severe mucositis. Enteral tube feeding may provide better nutritional support than oral intake in this population. However, more studies are needed to verify this finding.