The prevalence of weight loss during (chemo)radiotherapy treatment for lung cancer and associated patient- and treatment-related factors

Background & aims: Thoracic radiotherapy is associated with toxicities that can adversely impact nutritional intake. This study aimed to investigate the prevalence and predictors of >= 5% weight loss and commencement of enteral nutrition in lung cancer patients receiving radiotherapy. Methods: A retrospective study of 96 patients treated with high dose palliative or radical radiotherapy for a primary diagnosis of small cell or non-small cell lung cancer. Weight loss, was calculated between the start and up to 90 days from radiotherapy commencement. Associations between >= 5% weight loss and enteral feeding, and demographic and clinical factors (age, gender, nutritional status, total dose of radiotherapy, concurrent chemotherapy, disease stage, prior surgery, hyper-fractionation and performance status) were assessed. Results: The prevalence of weight loss >= 5% was 31% (median weight loss 8%, range 5-19%). The prevalence of commencement of enteral nutrition was 12%. Patients receiving concurrent chemotherapy were more likely to have >= 5% weight loss (40 versus 0%, phi = 0.35, p < 0.001). The odds of a patient with late stage disease having >= 5% weight loss were 15 times greater than for a patient with earlier disease stage (95% CI 1.97,122.8, p = 0.009). Only Patient Generated Subjective Global Assessment score was associated with starting enteral nutrition (r = 0.27, p = 0.03). Conclusion: Clinically significant weight loss is prevalent in lung cancer patients receiving radiotherapy and is associated with concurrent chemotherapy and late stage disease. Identification of factors associated with weight loss assists with early identification and intervention in patients at high nutritional risk. (C) 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.