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Research article
Liangping Xia
Sun Yat-sen University Cancer Center
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0104-7700
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: We aim to investigate the dynamic variation and prognostic value of weight loss among patients with nasopharyngeal carcinoma (NPC).
Methods: A total of 1149 newly diagnosed NPC patients who received radical radiotherapy (RT) were retrospectively analyzed. Patients’ weights were measured at initiation of RT and every week during RT. Recursive partitioning analyses (RPAs) were utilized to determine cut-off value for rate of weight loss (RWL). Disease-free survival (DFS) was our primary endpoint. Secondary endpoints included locoregional relapse-free survival (LRRFS), distant metastasis-free survival (DMFS), and overall survival (OS).
Results: RWLs were 0%, 0%, -1.54%, -2.86%, -4.11%, -5.98%, -6.56% at 1st, 2nd, 3rd, 4th, 5th, 6th, and 7th week of RT, respectively. RWL optimal threshold with respect to DFS was -5.3% based on RPAs. Thus, a consistent threshold of -5% (> -5% versus ≤ -5%) was selected to classify NPC patients into low RWL and high RWL groups for survival analysis. Compared to high RWL (≤-5%), patients with low RWL (> -5%) had significantly better ten-year DFS (78.6% versus 61.2%; P< 0.001), OS (86.6% versus 70.1%; P< 0.001), and DMFS (88.5% versus 80.2%; P = 0.007). However, no difference was observed between LRRFS groups (91.7% versus 94.3%; P= 0.173). In multivariate analysis, high RWL was an independent risk factor for DFS (HR, 1.56; 95% CI, 1.19-2.03; P= 0.001), OS (HR, 1.54; 95% CI, 1.11-2.15; P= 0.011) and DMFS (HR, 1.47; 95% CI, 1.03-2.10; P= 0.033) in patients with NPC. Additionally, chemotherapy and old age were attributed to the development of high RWL.
Conclusions: Weight loss during RT was significantly associated with decreased survival among NPC patients. Clinicians should continuously inform patients on the health impact of minimizing weight loss under 5%.
Keywords
Nasopharyngeal carcinoma, radiotherapy, weight loss, dynamic variation, prognostic value.
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A new preprint design is coming!
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This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Liangping Xia
Sun Yat-sen University Cancer Center
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0104-7700
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 12 Feb, 2021
No community comments so far
Reviewers invited
Invitations sent on 08 Apr, 2021
First submitted
On 07 Dec, 2020
Editor assigned
On 07 Dec, 2020
Submission checks complete
On 07 Dec, 2020
Editor invited
On 07 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: We aim to investigate the dynamic variation and prognostic value of weight loss among patients with nasopharyngeal carcinoma (NPC).
Methods: A total of 1149 newly diagnosed NPC patients who received radical radiotherapy (RT) were retrospectively analyzed. Patients’ weights were measured at initiation of RT and every week during RT. Recursive partitioning analyses (RPAs) were utilized to determine cut-off value for rate of weight loss (RWL). Disease-free survival (DFS) was our primary endpoint. Secondary endpoints included locoregional relapse-free survival (LRRFS), distant metastasis-free survival (DMFS), and overall survival (OS).
Results: RWLs were 0%, 0%, -1.54%, -2.86%, -4.11%, -5.98%, -6.56% at 1st, 2nd, 3rd, 4th, 5th, 6th, and 7th week of RT, respectively. RWL optimal threshold with respect to DFS was -5.3% based on RPAs. Thus, a consistent threshold of -5% (> -5% versus ≤ -5%) was selected to classify NPC patients into low RWL and high RWL groups for survival analysis. Compared to high RWL (≤-5%), patients with low RWL (> -5%) had significantly better ten-year DFS (78.6% versus 61.2%; P< 0.001), OS (86.6% versus 70.1%; P< 0.001), and DMFS (88.5% versus 80.2%; P = 0.007). However, no difference was observed between LRRFS groups (91.7% versus 94.3%; P= 0.173). In multivariate analysis, high RWL was an independent risk factor for DFS (HR, 1.56; 95% CI, 1.19-2.03; P= 0.001), OS (HR, 1.54; 95% CI, 1.11-2.15; P= 0.011) and DMFS (HR, 1.47; 95% CI, 1.03-2.10; P= 0.033) in patients with NPC. Additionally, chemotherapy and old age were attributed to the development of high RWL.
Conclusions: Weight loss during RT was significantly associated with decreased survival among NPC patients. Clinicians should continuously inform patients on the health impact of minimizing weight loss under 5%.
Figure 1
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