Study of cellular immunity in children and adolescents with nasopharyngeal cancer

Abstract

Background: Head & neck cancer patients treated with radical/adjuvant radiotherapy suffer from weight loss, the cause of which can be multifactorial. In this study we have evaluated weight loss pattern in H&N cancer patients receiving either conventional or conformal chemoradiotherapy (CCRT)/adjuvant radiotherapy (RT) and to find out possible factors. Methods: A retrospective study was done using data of already treated head & neck cancer patients. Inclusion criteria-1) Primary site: oral cavity, oropharynx, larynx, & hypopharynx. 2) Treated with either radical CCRT(with Inj. Cisplatin) or adjuvant RT. Exclusion criteria-1) palliative radiotherapy, 2)treatment gap >6 days. Basic parameters were collected, weight at beginning & at end of Radiotherapy noted. As general rule, Ryle's tube insertion was done only when needed (difficulty to swallow liquid). Results: 160 patients' data were collected: 80 patients-Conformal RT (40 patients radical CCRT & 40 patients adjuvant RT), 80 patients-Conventional RT (40 patients radical CCRT & 40 patients adjuvant RT). Only 5 patients (2 conformal CCRT & 3 conformal RT) out of total 160 patients gained weight during course of RT. Hence, 155 patients suffered weight loss. We compared variables with absolute weight loss of 5kg & >5kg using Chi square (v2) test. Also, variables were compared with relative weight loss of 10% & >10%. The variables affecting both absolute and relative weight loss were initial low KPS status, use of conventional RT technique and use of chemotherapy & higher radiation dose (>60Gy). It was also found that ryle's tube insertion was significantly more in patients with >5kg/>10% weight loss.