Weight loss compromises overall survival rate in people with head and neck cancer undergoing radiotherapy and chemotherapy

The compromise in the overall survival rate due to weight loss in people with head and neck cancer undergoing radiotherapy and chemotherapy is a topic of great importance, as it directly affects both the efficacy of the treatment and the patient’s quality of life. Weight loss in these patients, in many cases, is not only a consequence of the cancer itself, but also of the side effects of the treatment, such as mucositis, dysphagia, loss of taste and nausea, which compromise nutritional intake and, ultimately, the patient’s general condition.

Impact of weight loss on survival

Significant weight loss in patients with head and neck cancer during treatment with chemo and radiotherapy is associated with a decrease in the overall survival rate. This is due to several interrelated factors that affect both the course of treatment and the body’s response to the therapies. Weight loss in this population may be indicative of malnutrition, which can lead to a deterioration in immune status, affecting the body’s ability to fight cancer and tolerate the adverse effects of chemo and radiotherapy.

Studies have shown that patients who experience a weight loss of 10% or more during treatment have a worse prognosis in terms of overall survival compared to those who manage to maintain their weight or only have minimal loss. This deterioration in nutritional status is related to a reduced response to treatment, increased toxicity, and post-treatment complications such as infections, which increases the likelihood of interruptions in the therapeutic regimen. These interruptions can compromise the success of the treatment and, therefore, negatively impact the survival curve.

Factors contributing to weight loss

Treatment with chemotherapy and radiotherapy in head and neck cancer has serious side effects that affect the patient’s ability to eat properly. Among the most common are:

1. Mucositis and xerostomia: Inflammation of the oral mucosa and extreme dryness of the mouth are frequent side effects of radiotherapy in this area. These problems make it difficult to ingest solid and liquid foods, causing a significant reduction in daily caloric intake.

2. Dysphagia: Difficulty swallowing, which may worsen during treatment, affects the patient’s ability to consume food, especially those that are rich in protein and calories, essential for maintaining weight and combating cachexia (severe loss of muscle mass).

3. Taste alterations: Both radiation therapy and chemotherapy can alter the sense of taste, causing foods to be perceived as bitter, metallic, or tasteless. This contributes to loss of appetite, which in turn decreases nutritional intake.

4. Nausea and vomiting: These are common effects of chemotherapy, which can further limit patients’ ability to maintain an adequate diet during treatment.

Relationship between nutritional status and treatment tolerance

A compromised nutritional status can have a detrimental effect on patients’ tolerance to treatment. Those who lose significant weight are at increased risk of developing serious treatment-related side effects, such as infections, systemic toxicity, and dehydration, which may require temporary or permanent discontinuation of treatment. Interruptions in treatment directly affect therapeutic outcomes, decreasing the effectiveness of chemotherapy and radiation therapy, and increasing the likelihood of tumor recurrence and disease progression.

On the other hand, patients who maintain their weight and nutritional status are more likely to complete treatment as scheduled, which improves tumor control rates and therefore long-term survival. Appropriate nutritional management has been identified as a key intervention to optimize the outcomes of patients with head and neck cancer.

Importance of nutritional intervention

Early nutritional intervention is crucial to improve the prognosis of these patients. Strategies including regular nutritional monitoring, caloric and protein supplementation, and the use of alternative feeding methods, such as nasogastric or gastrostomy tube feeding, can help prevent weight loss and improve treatment tolerance.

In addition, collaboration between oncologists, nutritionists, and dieticians is essential to develop personalized feeding plans that are tailored to the needs of each patient, with the aim of ensuring adequate nutrient intake despite eating difficulties.

The compromise in the overall survival curve due to weight loss in people with head and neck cancer undergoing chemotherapy and radiotherapy underscores the critical importance of maintaining adequate nutritional status throughout the course of treatment. Weight loss and malnutrition not only impair patient quality of life, but also have a direct negative impact on treatment efficacy and overall survival. Early and ongoing nutritional interventions are essential to mitigate these effects and improve long-term outcomes in this vulnerable population.