Session Item

Weight loss (WL) during concurrent chemo-radiotherapy (CCR) for nasopharyngeal carcinomas (NPC) has been identified as a negative prognostic factor for disease-free survival. Therefore, maintaining a stable weight during treatment phase is essential to improve oncologic results. The aim of this study was to identify the quality of weight loss in order to propose the adequate diet to maintain a stable weight during treatment.

A prospective, monocentric study of 27 patients treated with CCR for NPC between August 2020 and March 2021. Median age was 54 years [35-65] with a sex ratio of 1.3. The majority of patients (96.29%) received first-line chemotherapy. All patients received intensity modulated radiotherapy at a dose of 69.96 Gy in 33 fractions with weekly cisplatin (40mg/m²) chemotherapy for 26 patients. Different parameters of WL (patient weight, fat mass and fat-free mass) were measured in the first day (FD), the 3rd or 4th week (MT) and the last day (LD) of treatment. For all parameters, difference was calculated as follow: MT – FD; LD – MT and LD – FD.

The mean WL was -2.9 kg [-8.8; 1.8], -4 kg [-9.4; -0.9] and -6.2 kg [-15.6; -2.5] between (MT – FD), (LD – MT) and (LD – FD) respectively (p=0.016).
The mean fat mass difference was -1.4 kg [-8.5; 4.2], -1.4 kg [-8.2; 7.8] and -2.6 kg [-11.2; 6.4] between (MT – FD), (LD – MT) and (LD – FD) respectively (p=0.4).
The mean fat-free mass difference was -1.1 kg [-7.1; 4.7], -2.5 kg [-27.8; 0.5] and -3.6 kg [-28.1; 2.6] between (MT – FD), (LD – MT) and (LD – FD) respectively (p=0.014).

The weight loss is continuous during the CCR of the NPC but it is more important during the 2nd treatment phase. It is mainly related to fat-free mass during the 2nd phase. A protein supplement should be prescribed to patients during the last phase of treatment to prevent major fat-free mass loss and thus decrease global WL.