Anemia, as an adverse event during chemoradiotherapy for head and neck cancer, contributes to a reduction in swallowing muscle mass and leads to dysphagia.

BACKGROUND

Chemoradiotherapy (CRT) for head and neck cancer (HNC) often leads to dysphagia and myelosuppression (e.g., neutropenia and anemia). This study investigated the associations between myelosuppression, muscle mass changes, and dysphagia in patients undergoing CRT for HNC.

METHODS

This retrospective observational study included 136 patients with HNC who underwent curative CRT between January 2019 and August 2024. Anemia (hemoglobin ≤ 8.0 g/dL) and neutropenia (absolute neutrophil count < 1000/mm3) were classified based on routine blood tests during CRT. The primary outcome was feeding tube dependency 3 months after completing CRT. Swallowing muscle mass was evaluated using the cross-sectional area of the tongue complex muscles (TCM).

RESULTS

On multivariate analysis, anemia was significantly associated with a decline in the TCM cross-sectional area (coefficient: 8.21, P < 0.001) and feeding tube dependency (odds ratio: 5.25, P = 0.02). In contrast, neutropenia had no significant impact on either.

CONCLUSIONS

Anemia, an adverse effect of CRT for HNC, was an independent risk factor for feeding tube dependency at 3 months post-CRT and was significantly associated with a decline in the TCM cross-sectional area.