On-treatment body composition monitoring of H&N cancer patients
Research type
Research Study
Full title
Validation and deployment of on-line monitoring of body composition of patients being treated with radiotherapy for head and neck cancer.
IRAS ID
350371
Contact name
Alan McWilliam
Contact email
Sponsor organisation
University of Manchester
Duration of Study in the UK
0 years, 8 months, 30 days
Research summary
Head and neck cancer is the 7th most common cancer globally, with over 12,000 new cases in the UK each year, which is projected to increase by 30% by 2030. Malnutrition is common in these patients, driven by cancer-related metabolic changes, and difficulties in chewing and swallowing caused by the disease growing close to critical structures. Patients are treated with a combination of surgery, chemotherapy, and radiotherapy, each with treatment related side-effects, including dry mouth, dental complications and swallowing dysfunction further impacting malnutrition and body composition.
Radiotherapy, the targeted delivery of x-rays directly to the cancer, is part of the treatment pathway for up to 85% of patients with head and neck cancer (disease stage dependent), typically delivered over 6 weeks. Approximately 60% of patients lose weight during treatment and require dietary interventions. During radiotherapy treatment daily imaging is routinely acquired which provides the opportunity to identify the underlying mode of body composition change. Interventions are currently triggered by weight loss alone, however changes in body composition, particularly muscle mass, have been associated with differences in survival and treatment toxicities. Close monitoring of body composition during treatment will better identify patients where different interventions are needed and will identify patients where further interventions are required.
In our preliminary analysis, of 197 on average, patients lost weight and muscle mass during radiotherapy, but patients who maintained or gained weight, but lost muscle had significantly worse survival (figure, red survival line). As these patients maintained weight, no nutritional interventions are triggered. We hypothesise that continual monitoring of body composition during radiotherapy could trigger personalised nutritional or treatment interventions, improving patient outcomes.
For this silent prospective study we aim to demonstrate the feasibility of extracting muscle mass and presenting this data to clinical teams in an explainable and timely manner allowing personalised interventions.
REC name
London - Brent Research Ethics Committee
REC reference
24/PR/1554
Date of REC Opinion
8 Jan 2025
REC opinion
Favourable Opinion