Weight gain as an indicator of response to chemotherapy for oesophageal carcinoma

• Published in: Clinical oncology (Royal College of Radiologists (Great Britain)) 1995, Vol.7 (6), p.382-384
• Main Authors: Steyn, R.S., Grenier, I., Darnton, S.J., Cullen, M.H., Matthews, H.R.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic agents; Antineoplastic Agents - therapeutic use; Biological and medical sciences; Carcinoma; Chemotherapy; Esophageal Neoplasms - drug therapy; Female; General aspects; Humans; Male; Medical sciences; Middle Aged; Oesophagus; Pharmacology. Drug treatments; Treatment Outcome; Weight change; Weight Gain - drug effects
• ISSN: 0936-6555; 1433-2981
• DOI: 10.1016/S0936-6555(05)80010-X

Patients with oesophageal carcinoma commonly present with dysphagia and weight loss, which may be related to the tumour burden and/or the physical obstruction to the passage of food. In this study we have examined the relationship between weight change and response to chemotherapy in 28 patients undergoing neo-adjuvant chemotherapy for squamous or anaplastic carcinoma. Two pulses of mitomycin, ifosfamide and cisplatin were given 3 weeks apart. Body weights were measured prior to the first pulse and 3 weeks after the second. Patients underwent oesophageal dilatation routinely at diagnostic endoscopy prior to chemotherapy, in order to permit oral nutrition. No dietary modifications were made. Tumour response was assessed on a barium swallow. Patients had a normal spread of weights on presentation. In the non-responding group ( n = 9), eight patients lost weight and one gained weight. Of the partial responders (>50% tumour shrinkage; n = 11), five gained weight, five lost weight and one remained constant. In the complete response group ( n = 8), six gained weight and two lost weight. Statistical analysis showed a significant difference (F = 4.61; P = 0.02) between change in weight expressed as a percentage of ideal weight in non-responders (mean −5.3%) versus partial responders (mean +2.4%), and in non-responders versus complete responders (mean +1.1%). Weight gain during chemotherapy is a good indication of response, although its absence does not preclude a response. In the majority of patients who respond to chemotherapy there will be an increase in weight with improvement in their general condition prior to operation.