Weight loss and radical radiotherapy

Weight loss is common in patients with cancer and can often be the first sign of underlying disease. Over the course of cancer treatment weight loss can be a significant cause of psychological distress, and reduction in physical function and quality of life. In patients receiving radical radiotherapy, weight loss can have implications for short term treatment outcomes and can lead to breaks in treatment. Significantly, weight loss before radiotherapy and weight loss during treatment have both been associated with poorer long term outcomes including late toxicities and poorer overall survival. The sequelae of weight loss specific to radiotherapy is that it may affect the accuracy of treatment and dose of radiotherapy to the tumour or organs at risk, particularly in head and neck treatments.

The significant implications of weight loss for patients receiving radical radiotherapy mark it as an urgent clinical priority for research and the development of therapeutic strategies. Radiotherapy related weight loss includes two overlapping but distinct clinical syndromes – malnutrition and cancer cachexia, both of which will be discussed here.

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