Effects of induction chemotherapy on nutrition status in locally advanced nasopharyngeal carcinoma: a multicentre prospective study

Autor: Jingjing Miao, Lin Wang, Enya H.W. Ong, Chaosu Hu, Shaojun Lin, Xiaozhong Chen, Yuanyuan Chen, Yahua Zhong, Feng Jin, Qin Lin, Shaomin Lin, Xuefeng Hu, Ning Zhang, Rensheng Wang, Cong Wang, Xiang Guo, Nelson L.F. Yit, Hanping Shi, Sze Huey Tan, Haiqiang Mai, Conghua Xie, Melvin L.K. Chua, Chong Zhao
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of Cachexia, Sarcopenia and Muscle, Vol 14, Iss 2, Pp 815-825 (2023)
Druh dokumentu: article
ISSN: 2190-6009
2190-5991
DOI: 10.1002/jcsm.13196
Popis: Abstract Background Induction chemotherapy (IC) and concurrent chemoradiotherapy (CCRT) is the standard of care for locoregionally advanced nasopharyngeal carcinoma (LA‐NPC). This intensive treatment regimen increases acute toxicities, which could negatively impact patients' nutritional status. We conducted this prospective, multicentre trial to investigate the effects of IC and CCRT on nutritional status in LA‐NPC patients, so as to provide evidence for further study of nutritional intervention, which was registered in ClinicalTrials.gov (NCT02575547). Methods Patients with biopsy‐proven NPC and planned for IC + CCRT were recruited. IC entailed two cycles of 3‐weekly docetaxel 75 mg/m2 and cisplatin 75 mg/m2; CCRT entailed two to three cycles of 3‐weekly cisplatin 100 mg/m2 depending on the duration of radiotherapy. Nutritional status and quality of life (QoL) were assessed pre‐IC, post‐cycles one and two of IC, W4 and W7 of CCRT. Primary endpoint was the cumulative proportion of ≥ 5.0% weight loss (WL5.0) by the end of treatment (W7‐CCRT). Secondary endpoints included body mass index, NRS2002 and PG‐SGA scores, QoL, hypoalbuminaemia, treatment compliance, acute and late toxicities and survivals. The associations between primary and secondary endpoints were also evaluated. Results One hundred and seventy‐one patients were enrolled. Median follow‐up was 67.4 (IQR: 64.1–71.2) months. 97.7% (167/171) patients completed two cycles of IC, and 87.7% (150/171) completed at least two cycles of concurrent chemotherapy; all, except one patient (0.6%), completed IMRT. WL was minimal during IC (median of 0.0%), but increased sharply at W4‐CCRT (median of 4.0% [IQR: 0.0–7.0%]) and peaked at W7‐CCRT (median of 8.5% [IQR: 4.1–11.7%]). 71.9% (123/171) of patients recorded a WL5.0 by W7‐CCRT, which was associated with a higher malnutrition risk (NRS2002 ≥ 3 points: 87.7% [WL ≥ 5.0%] vs 58.7% [WL
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