Linking Body Composition Changes To Swallowing Function And Nutritional Autonomy During Chemoradiation

Abstract

Chemoradiation therapy (CRT) is commonly associated with treatment-related toxicities that impair swallowing function. Emerging evidence indicates that changes in body composition, particularly loss of lean mass, contribute to swallowing dysfunction during and after treatment. Traditional reliance on body weight alone may obscure clinically relevant alterations in lean and fat mass that influence functional outcomes. This scientific review examines longitudinal changes in body composition during and following CRT and evaluates their associations with swallowing function, with dietary intake considered as a contributing factor influencing body composition trajectories. Evidence from longitudinal and observational studies in adult patients undergoing curative-intent CRT has been synthesized to evaluate trends in dietary intake, body composition parameters, and functional outcomes. The reviewed literature indicates that reduced dietary intake during CRT is consistently associated with progressive loss of lean mass over time. Greater lean mass depletion has been associated with poorer swallowing function and a higher likelihood of compromised nutritional autonomy during and after treatment. In contrast, changes in fat mass demonstrate weaker and less consistent relationships with functional outcomes. These findings highlight the importance of lean mass preservation as a key determinant of swallowing function during CRT, with dietary intake playing a critical role in modulating body composition changes. Incorporating routine body composition assessment and early, targeted nutritional interventions into oncologic care may help mitigate treatment-related toxicities and support functional recovery.