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Original Article
Chemoradiotherapy Increases the Incidence Rate of Cachexia in Head and Neck Cancer: A Cohort Study
Nan-Chin Lin1orcid , Kuo-Ting Sun2,3orcid , Yu-Hsin Tseng4, Tzong-Ming Shieh3orcid , Yin-Hwa Shih5orcid

DOI: https://doi.org/10.4143/crt.2025.482 [Accepted]
Published online: October 30, 2025
1Department of Oral and Maxillofacial Surgery, Show-Chwan Memorial Hospital, Changhua, Taiwan
2Department of Pediatric Dentistry, China Medical University Hospital, Taichung, Taiwan
3School of Dentistry, China Medical University, Taichung, Taiwan
4Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
5Department of Healthcare Administration, Asia University, Taichung, Taiwan
Corresponding author:  Tzong-Ming Shieh
Email: tmshieh@mail.cmu.edu.tw
Yin-Hwa Shih
Tel: 86-4-23323456 (#20040) 
Email: evashih@gm.asia.edu.tw
Nan-Chin Lin and Kuo-Ting Sun contributed equally to this work.
Received: 6 May 2025   • Accepted: 15 October 2025
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Purpose
In Taiwan, head and neck cancer (HNC) ranks among the five most prevalent cancers in men. HNC tumours can impair the patient's ability to ingest food following treatment, which may lead to cachexia. Currently, in Taiwan, no study has investigated the association between the risk of cachexia and the patients’ clinical characteristics.
Materials and Methods
This retrospective cohort study analysed data from the cancer registry database of Show-Chwan Memorial Hospital between 2021-2022. We evaluated 115 patients who underwent initial treatment and assessed the presence of cachexia 6 months after treatment. Clinical data were collected and compared between patients with cachexia and those without cachexia to explore the associated risk factors in the HNC population.
Results
In the database, oral cancer constituted the primary diagnosis for 70% of cases. According to pathological assessments, most patients presented with locally advanced disease and moderate tumour differentiation. No correlation was observed between patient-reported complications, risk behaviours, and the incidence of cachexia. Notably, patients who underwent concurrent chemoradiotherapy exhibited a 3.8-fold higher risk of developing cachexia.
Conclusion
Concurrent chemotherapy is the leading risk factor of treatment-induced cachexia. The results of this study could help clinicians manage this issue adequately and devise solutions to limit its incidence.

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    Chemoradiotherapy Increases the Incidence Rate of Cachexia in Head and Neck Cancer: A Cohort Study
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