Impact of weight loss on adverse events during chemoradiotherapy in patients with small cell lung cancer: a retrospective study.

PURPOSE: Radiation oesophagitis, a common adverse event of radiation therapy for limited-disease small cell lung cancer (LD-SCLC), results in significant weight loss. This study retrospectively evaluated the association between weight loss and treatment outcomes in patients with LD-SCLC undergoing chemoradiotherapy and explored the associated factors.

METHODS

Patients with LD-SCLC treated with concurrent chemoradiotherapy between 2010 and 2023 were included. We compared the characteristics of patients with and without radiation oesophagitis or ≥ 5% weight loss during treatment.

RESULTS

Of 99 patients included, radiation oesophagitis occurred in 71. The incidence of febrile neutropenia (FN) was significantly higher in the grade 2-3 oesophagitis group than in the grade 0-1 group (72.7% vs. 45.5%; P = 0.030). In patients with FN, creatinine clearance significantly decreased after treatment (84.2 ± 21.4 mL/min to 76.5 ± 20.4 mL/min; P < 0.001). Twenty-five patients (25.3%) had ≥ 5% weight loss by the end of radiotherapy. Patients with ≥ 5% weight loss had a significantly higher incidence of FN than those with < 5% weight loss (80.0% vs. 43.2%; P = 0.002). On multivariate logistic regression analysis, FN was significantly associated with weight loss ≥ 5% (OR 4.49, 95% CI 1.47-13.80; P = 0.009).

CONCLUSION

This study suggests that weight loss of ≥ 5% during chemoradiotherapy is associated with an increased incidence of FN among patients with LD-SCLC. These preliminary findings suggest that the clinical utility of close monitoring and early supportive care for patients at risk of weight loss warrants further prospective investigation.