Retrospective study of impact of weight loss on adverse events during chemoradiotherapy for small cell lung cancer

Radiation esophagitis, a common adverse event of radiation therapy for limited-disease small cell lung cancer (LD-SCLC) results in significant weight loss. A retrospective study at the National Cancer Center Hospital (Tokyo, Japan) evaluated the association between weight loss and treatment outcomes in patients with LD-SCLC undergoing concurrent chemoradiotherapy (cCRT) between 2010 and 2023. Of 99 patients, radiation esophagitis occurred in 71. The incidence of febrile neutropenia (FN) was significantly higher in the grade 2-3 esophagitis group than in the grade 0-1 group (72.7% versus 45.5%; p=0.030). In patients with FN, creatinine clearance significantly decreased after treatment (84.2 ± 21.4 mL/min toe 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 compared with those with < 5% weight loss (80.0% versus 43.2%; p=0.002). On multivariate logistic regression analysis, FN was significantly associated with weight loss ≥ 5% (OR 4.49; p=0.009). The authors conclude that weight loss of ≥ 5% during cCRT was associated with and increased incidence of FN among patients with LD-SCLC.