Overview
Chemoradiotherapy is the standard treatment for unresectable locally advanced head and neck
cancer (HNC). However, malnutrition is present in 44-88% HNC patients during
chemoradiotherapy, which leads to loss of skeletal muscle mass (SMM) and poor clinical
outcomes. Timely assessment of SMM and early intervention of malnutrition are particularly
important for HNC patients undergoing radiotherapy. However, body composition and skeletal
muscle loss are not accurately reflected by the current assessment tools of malnutrition,
which only measure body mass index and body weight loss.
Cone-beam CT (CBCT), a variation of traditional CT, is widely performed to ensure the
appropriate position of the patients during radiotherapy. The previous study showed that
measuring skeletal muscle areas and its changes using CBCT during radiotherapy is feasible.
The hypothesis of this study is loss of SMM is associated with severe adverse effects in HNC
patients during radiotherapy compared with body weight loss.
Description
This is a prospective observational phase II study. Patients with locally advanced HNC
scheduled to receive radical radiotherapy are prospectively enrolled in this study. CBCT and
body weight are obtained before radiotherapy and once a week during radiotherapy. Severe
adverse effects including grade 3-4 mucositis, dermatitis, haematological toxicity,
interruption of radiotherapy, delayed chemotherapy, and unplanned admission are recorded
during radiotherapy.
Eligibility
Inclusion Criteria:
- Histologically confirmed HNC including Oral Cavity, Oropharyngeal, Nasopharynx, Hypopharyngeal, and Laryngeal Cancers
- Clinical stage II-IVa according to the American Joint Committee of Cancer (the seventh edition)
- Eastern Cooperative Oncology Group (ECOG) performance status 0-2
Exclusion Criteria:
- Previous head and neck radiotherapy
- Previous cervical lymph node dissection
- Active infections
- Palliative treatment