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Purpose <p>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.</p> Methods <p>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.</p> Results <p>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%; <i>P</i> = 0.030). In patients with FN, creatinine clearance significantly decreased after treatment (84.2 ± 21.4&#xa0;mL/min to 76.5 ± 20.4&#xa0;mL/min; <i>P</i> &lt; 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 &lt; 5% weight loss (80.0% vs. 43.2%; <i>P</i> = 0.002). On multivariate logistic regression analysis, FN was significantly associated with weight loss ≥ 5% (OR 4.49, 95% CI 1.47–13.80; <i>P</i> = 0.009).</p> Conclusion <p>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.</p>

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

  • 期刊论文

  • 发表日期：

    2026年6月27日

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  • Yoshimasa Saito,
  • Mai Kawarade,
  • Reiko Ando Makihara,
  • Naomi Sakiyama,
  • Makoto Maeda,
  • Akiko Tateishi,
  • Yuki Shinno,
  • Yusuke Okuma,
  • Tatsuya Yoshida,
  • Hidehito Horinouchi,
  • Noboru Yamamoto,
  • Yasushi Goto,
  • Hironobu Hashimoto

摘要

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.