Publication: Impact of Weight Loss on Patients with Locally Advanced Esophageal and Esophagogastric Junction Cancers Treated with Chemoradiotherapy
Issued Date
2021-01-01
Resource Type
ISSN
2476762X
15137368
15137368
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2-s2.0-85122560179
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Mahidol University
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SCOPUS
Bibliographic Citation
Asian Pacific Journal of Cancer Prevention. Vol.22, No.12 (2021), 3847-3855
Suggested Citation
Jirapath Wiwitkeyoonwong, Chuleeporn Jiarpinitnun, Pitichote Hiranyatheb, Nuttapong Ngamphaiboon Impact of Weight Loss on Patients with Locally Advanced Esophageal and Esophagogastric Junction Cancers Treated with Chemoradiotherapy. Asian Pacific Journal of Cancer Prevention. Vol.22, No.12 (2021), 3847-3855. doi:10.31557/APJCP.2021.22.12.3847 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/76315
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Title
Impact of Weight Loss on Patients with Locally Advanced Esophageal and Esophagogastric Junction Cancers Treated with Chemoradiotherapy
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Abstract
Introduction: Malnutrition and weight loss are commonly observed in patient with esophageal and esophagogastric junction (EGJ) cancers. Chemoradiotherapy (CRT) is a mainstay of treatment for locally advanced esophageal and EGJ cancers. Impact of weight loss on patients with treated with CRT was not well studied. Methods: Patients with locally advanced esophageal and EGJ cancer who received CRT were identified in our institutional database and allocated into low (LWL) and high (HWL) weight loss groups. HWL was defined as weight loss >5% of baseline during CRT. Results: A total of 167 patients were underwent definitive (n=89) or preoperative (n=78) CRT, respectively. HWL was observed in 46% and 55% of patients treated with definitive and preoperative CRT, respectively. Cisplatin/5FU regimen used during CRT was a significant predictive factor for weight loss in multivariate analysis (OR 2.07, 95% CI 1.09–3.94; p=0.026). In the definitive CRT group, patients in the HWL group experienced significantly worse overall survival than those in the LWL group (1.2 years vs 1.95 years; p=0.003). Multivariate analysis revealed that baseline albumin (>3.0 g/dL) was significantly associated with longer OS of definitive CRT patients (HR 2.15, 95% CI 1.1-4.19; p=0.024). Tolerability and toxicities during CRT were not statistically different between groups. Conclusion: Significant weight loss during CRT was frequently observed in patients with locally advanced esophageal and EGJ cancers. Baseline hypoalbuminemia was an independent prognostic factor for OS in patients treated with definitive CRT. Nutritional support before and during treatment should be considered to potentially improve patients’ outcomes