J. Cacicedo

A prospective analysis of factors that influence weight loss in patients undergoing radiotherapy

Malnutrition occurs frequently in patients with cancer. Indeed, a variety of nutritional and tumor-related factors must be taken into account in these patients. Recognizing this relationship, we aimed to prospectively evaluate the risk factors that influence weight loss in patients undergoing radiotherapy with oral nutritional supplementation and dietetic counseling. Weight loss of 74 patients during radiotherapy and 1 month after treatment was analyzed. Parameters such as age, gender, tumor location, tumor stage, Eastern Cooperative Oncology Group performance status (ECOG PS) score, and the use of chemotherapy were analyzed to evaluate their influence on weight loss. All patients underwent oral nutritional supplementation and dietetic counseling. Forty-six (65.7%) patients lost weight, with a mean weight loss of (4.73 ± 3.91) kg, during radiotherapy. At 1 month after treatment, 45 (66.2%) patients lost weight, presenting a mean weight loss of (4.96 ± 4.04) kg, corresponding to a (6.84 ± 5.24)% net reduction from their baseline weight. Head and neck cancer patients had a mean weight loss of (3.25 ± 5.30) kg, whereas the remaining patients had a mean weight loss of (0.64 ± 2.39) kg (P = 0.028) during radiotherapy. In the multivariate analysis, the head and neck tumor location (P = 0.005), use of chemotherapy (P = 0.011), and ECOG PS score of 2-3 (P = 0.026) were considered independent risk factors. Nutritional status and parameters, such as tumor location (especially the head and neck), the use of chemotherapy, and the ECOG PS score, should be evaluated before radiotherapy because these factors can influence weight loss during radiotherapy and 1 month after treatment.

The next generation of radiation oncologists: Challenges and perspectives.

The field of oncology has undergone many changes in the last few years and due to the ever-growing complexity of the discipline it is imperative that specialists receive extensive training, and for this reason training programs in radiation oncology are among the most comprehensive of all specialities. Oncologists require wide-ranging training in basic science as well as in clinical medicine. These specialists need to know how to manage the side-effects of systemic treatments and radiotherapy, and even surgery. All specialists working in oncology must also be prepared to use a therapeutic approach to patient care that involves collaborative efforts, working together with other specialists through multidisciplinary tumor boards.1 In the speciality of radiation oncology, rigorous preparation is becoming even more important due to the emergence of new diagnostic and therapeutic strategies. In recent years, new technologies have revolutionized the field: intensity-modulated radiotherapy (IMRT), volumetric-modulated arc therapy (VMAT), image-guided RT (IGRT), and stereotactic body RT (SBRT).2,3 Importantly, some of these techniques are even capable of achieving results comparable to those traditionally obtained only through surgery.4–6 As a result, it is essential that we encourage young radiation oncologists to constantly make efforts to develop their knowledge and skills in the three fundamental areas of the field: basic research, clinical knowledge, and technical understanding.