Usefulness of clinical pathway in weight loss reduction during chemoradiotherapy for head and neck cancer

Chemoradiotherapy for head and neck cancer （HNC） causes various adverse events, among which weight loss is a major concern. Methodologies for the prevention and care of adverse events have not yet been standardized; therefore, we created a clinical pathway （CP） as a tool for standardized assessment and care. In this study, we assessed whether CP is useful in weight loss reduction during chemoradiotherapy for HNC. We retrospectively analyzed 108 patients who underwent treatment with high-dose cisplatin concurrent with radiotherapy （CRT） and cetuximab concurrent with radiotherapy （BRT） from January 2014 to March 2020. We stratified the patients into those with and without a CP. In CRT, the maximum weight loss rate was not significantly reduced in the CP-use group; however, aggravation of oral mucositis was suppressed in the CP-use group （p ＝ 0.043）. In BRT, the maximum weight loss rate was significantly reduced in the CP-use group compared with the non-use group （p ＝ 0.011）, and oral mucositis was equally suppressed in the CP-use group （p ＝ 0.037）. We believe that in BRT, using CP is effective in the weight loss reduction that occurs during the treatment.