The Association of Change in Weight During Radiotherapy Treatment With Clinical Outcomes in Patients With Stage I–III Esophageal Cancer

Abstract

Esophageal carcinoma (EC) and nutritional status are strongly linked due to swallowing disruptions and treatment-related toxicities. Therefore, malnutrition and weight loss (WL) occur in 85% and 79% of EC patients, respectively. WL is frequently associated with worse EC patient outcomes, however, WL during radiation therapy (RT) and EC patient outcomes have not been well established. The purpose of this study is to retrospectively review the association of WL during RT treatment of EC with clinical outcomes. Non-metastatic EC patients from our institution treated between 2010 and 2018, receiving total prescribed dose >40 Gy and aged >18 years, were included. Patients were analyzed by WL during RT, with categories of ≥5% vs. <5% and ≥10% vs. <10%. Patient characteristics and treatment regimens were similar across all WL groups. In univariate analysis, ≥5% and ≥10% WL were significantly associated with both worse overall survival (OS) and progression-free survival (PFS), and ≥10% WL was significantly associated with increased local recurrence. In multivariate analysis, ≥5% WL was significantly associated with OS and PFS. With both ≥5% and ≥10% WL throughout the radiation treatment being detrimental to OS and PFS. The importance of nutritional support in EC patients receiving radiotherapy is further validated.

Author Contribution

Conception and design: Youssef Youssef, Mark Niglas, Carrie Lavergne. Data collection: Andrew Youssef, Abrielle Fulton, Ayesha Fathima, Deanna N. G. Humphreys. Analysis and interpretation of the data: Mark Niglas, Andrew Youssef, Carrie Lavergne. Drafting the paper: Andrew Youssef. Revising critically for intellectual content: Andrew Youssef, Carrie Lavergne, Abrielle Fulton, Ayesha Fathima, Deanna N. G. Humphreys, Mark Niglas, Youssef Youssef. Final approval of the version to be published: Andrew Youssef, Carrie Lavergne, Abrielle Fulton, Ayesha Fathima, Deanna N. G. Humphreys, Mark Niglas, Youssef Youssef. All authors agree to be accountable for all aspects of the work.

Disclosure Statement

The authors declare no conflict of interest.

Funding

No funding was received for this study.

Data Availability Statement

Data not available – participant consent.