1. Methods
• Retrospective
patient
information
(n=25)
was
collected
which
included
the
following:
age
at
diagnosis,
gender,
tumor
site,
tumor
stage,
height
and
weight,
and
enteral
nutrition
information
(if
applicable).
Of
the
25
records
reviewed,
5
did
not
contain
tumor
stage
and
7
did
not
include
height.
• Weight
change
over
the
5-­‐week
period
was
calculated
by
subtracting
starting
weight
from
ending
weight,
measured
in
kilograms.
• Percent
weight
change
was
calculated
by
dividing
weight
change
in
kilograms
by
starting
weight
in
kilograms
and
multiplying
by
100.
• The
statistical
package
for
Excel
2011
for
Mac
StatPlus:
Mac
LE
(Build
6.0.3)
was
used
for
all
statistical
analyses.
• A
sample
means
t-­‐test
was
used
to
examine
the
statistical
signiRicance
of
the
observed
weight
change.
• Multiple
linear
regression
was
used
to
examine
the
strength
of
relationship
between
predictors
–
age,
gender,
tumor
site
–
and
the
response
variable
–
percent
weight
change.
• A
p
value
of
<0.05
was
considered
statistically
signiRicant
for
all
statistical
analyses.
Impact
of
Squamous
Cell
Carcinoma
of
the
Head/Neck
on
Weight
Status
Abigail
R.
Smith
UK
DHN
CP
Class
2016
Research
Mentor:
Aaron
Schwartz,
MS
RD
LD
Abstract
The
purpose
was
to
examine
the
impact
of
diagnosis
and
treatment
of
squamous
cell
carcinoma
of
the
head/neck
(SCCHN)
on
weight
status
over
a
5-­‐week
period.
A
sample
of
25
SCCHN
patients
treated
with
radiation
therapy
for
a
minimum
of
5
weeks
was
retrospectively
analyzed.
Comparison
of
the
mean
weight
change
over
the
5-­‐week
period
did
not
yield
statistically
signiRicant
results
(p=0.72).
The
average
weight
loss
over
5
weeks
was
3.12%
(2.38
kg).
Multiple
linear
regression
examining
the
association
between
explanatory
variables
–
age,
gender,
tumor
site
–
and
the
response
variable
–
percent
weight
change
–
explained
13.44%
of
weight
change
in
this
population
(R2
=0.13442).
Each
additional
year
of
age
was
associated
with
a
0.087%
weight
loss
(p=0.13).
Men
were
associated
with
2.19%
less
weight
loss
over
5
weeks
than
women
(p=0.38).
Oral
tumor
site
was
associated
with
a
3.05%
greater
weight
loss
over
5
weeks
when
compared
to
other
tumor
H/N
tumor
sites
(p=0.058).
Though
results
did
not
reach
statistical
signiRicance,
this
study
suggests
substantial
clinical
implications.
Data
regarding
the
anticipated
average
weight
loss
and
risk
factors
for
increased
weight
loss
in
HNC
patients
could
be
used
to
guide
healthcare
professionals
and
caregivers
in
choosing
an
optimal
prophylactic
nutrition
strategy.
Hypothesis
Individuals
diagnosed
with
and
treated
for
squamous
cell
carcinoma
of
the
head/neck
(SCCHN)
will
experience
signiRicant
weight
loss
within
the
Rirst
5
weeks
of
treatment
with
radiation
therapy.
Objectives
To
measure
the
average
weight
change
of
individuals
treated
for
SCCHN
within
the
Rirst
5
weeks
of
treatment
with
radiation
therapy
and
to
identify
risk
factors
for
increased
weight
loss
within
this
population.
Results
• An
examination
of
weight
change
over
the
5-­‐week
treatment
period
did
not
yield
statistically
signiRicant
results.
• The
average
weight
change
in
the
5-­‐week
period
was
a
loss
of
2.38
kg.
• The
average
percent
weight
loss
was
3.12%.
• The
sample
means
t-­‐test
for
comparing
the
mean
starting
and
ending
weight
(kg)
resulted
in
a
p
value
of
0.72.
• Multiple
linear
regression
examining
the
association
between
explanatory
variables
–
age,
gender,
tumor
site
–
and
the
response
variable
–
percent
weight
change
–
explained
13.44%
of
weight
change
in
this
population
(R2
=0.13442).
Discussion/Conclusions
• The
observed
results
were
in
agreement
with
current
research.
Patients
undergoing
treatment
for
SCCHN
experience
weight
loss1,2.
Female
gender
and
oral
tumor
site
were
risk
factors
associated
with
increased
weight
loss
in
SCCHN
patients3.
• Future
studies
with
a
larger
sample
size
and
an
expanded
research
design
that
allows
access
to
more
complete
patient
information
as
well
as
a
timeline
that
allows
researchers
to
follow
patients
during
and
after
treatment
may
yield
statistically
signiRicant
results.
• Although
the
observed
weight
change
was
not
statistically
signiRicant,
it
is
clinically
signiRicant.
There
was
a
3.12%
observed
weight
loss
in
5
weeks
compared
to
the
deRinition
of
cachexia
which
is
5%
weight
loss
in
3-­‐12
months4.
• Data
regarding
the
anticipated
average
weight
loss
and
risk
factors
for
increased
weight
loss
in
HNC
patients
could
be
used
to
guide
healthcare
professionals
and
caregivers
in
choosing
an
optimal
prophylactic
nutrition
strategy
based
on
the
presence
or
absence
of
these
risk
factors.
References
1. Platek,
M.
E.,
Myrick,
E.,
Mccloskey,
S.
A.,
Gupta,
V.,
Reid,
M.
E.,
Wilding,
G.
E.,
.
.
.
Singh,
A.
K.
(2013).
Pretreatment
weight
status
and
weight
loss
among
head
and
neck
cancer
patients
receiving
deRinitive
concurrent
chemoradiation
therapy:
Implications
for
nutrition
integrated
treatment
pathways.
Supportive
Care
in
Cancer,
21(10),
2825-­‐2833.
doi:10.1007/s00520-­‐013-­‐1861-­‐0
2. Silver,
H.
J.,
Guimaraes,
C.
D.,
Pedruzzi,
P.,
Badia,
M.,
Carvalho,
A.
S.,
Oliveira,
B.
V.,
.
.
.
Pietrobon,
R.
(2010).
Predictors
of
functional
decline
in
locally
advanced
head
and
neck
cancer
patients
from
South
Brazil.
Head
Neck
Head
&
Neck,
32(9),
1217-­‐1225.
doi:10.1002/hed.21322
3. Zhao,
J.,
Zheng,
H.,
Li,
L.,
Zhang,
L.,
Zhao,
Y.,
&
Jiang,
N.
(2015).
Predictors
for
Weight
Loss
in
Head
and
Neck
Cancer
Patients
Undergoing
Radiotherapy.
Cancer
Nursing,
38(6).
doi:10.1097/ncc.0000000000000231
4. Von
Haehling,
S.,
&
Anker,
S.
D.
(2010).
Cachexia
as
a
major
underestimated
and
unmet
medical
need:
facts
and
numbers.
Journal
of
Cachexia,
Sarcopenia
and
Muscle,
1(1),
1–
5.
http://doi.org/10.1007/s13539-­‐010-­‐0002-­‐6
2
2
82.54
80.16
78.5
79
79.5
80
80.5
81
81.5
82
82.5
83
Starting
Weight
Ending
Weight
Weight
(kg)
Figure
2:
Comparison
of
average
starting
and
ending
weights
Design
A
retrospective
observational
study
was
used
to
collect
data
for
review.
Patients
diagnosed
with
an
oral
or
throat
squamous
cell
carcinoma
tumor
and
treated
with
radiation
therapy
for
a
minimum
of
5
weeks
at
the
time
of
data
collection
were
eligible
for
this
review.
Setting
Data
collection
took
place
in
the
Radiation
Medicine
Department
at
a
community
cancer
center
in
Central
Kentucky.
Figure
1:
High
power
view
of
squamous
cell
carcinoma
malignancy