Correlation of Red Cell Distribution Width (RDW) With Weight Loss and Grade of Mucositis in Patients Who Underwent...

Red cell distribution width (RDW) is an emerging biomarker associated with systemic inflammation, nutritional status, and prognosis in various cancers. However, its correlation with treatment-related toxicities such as mucositis and weight loss in head and neck cancer patients undergoing radiotherapy remains underexplored.

This study aimed to evaluate the correlation between RDW (pre-treatment, post-treatment, and delta) with weight loss and mucositis severity in patients who received head and neck radiotherapy, with or without concurrent chemotherapy.

A retrospective analysis was conducted on 165 patients treated between 2023 and 2024 at Sri Devaraj Urs Medical College, Kolar. Ethics approval was obtained from the Institutional Ethics Committee, and informed consent was waived owing to the retrospective nature of the study. Patients with recurrent disease, inflammatory or autoimmune disorders, or second malignancies were excluded. Weekly data on weight, mucositis grade, and hematological parameters, including RDW, were extracted from case records. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26 (Released 2020; IBM Corp., Armonk, New York, United States), and Spearman correlation was used to assess associations.

RDW delta showed a significant positive correlation with weight loss from week 2 to week 7, with the strongest association in week 6 (r = 0.253, p = 0.002). Logistic regression confirmed RDW delta was a statistically significant marker associated with >10% weight loss (odds ratio (OR) = 1.13, p = 0.032). In contrast, RDW showed weak and inconsistent correlations with mucositis grade, achieving significance only in week 2 (r = 0.225, p = 0.005).

RDW delta is a promising, cost-effective biomarker associated with weight loss during head and neck radiotherapy. However, its role as a marker for mucositis severity appears limited.