Malnutrition, Decreased QOL Possible After Radiation Therapy for Head and Neck Cancer

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Adverse events associated with HNC treatment can lead to malnutrition.
Adverse events associated with HNC treatment can lead to malnutrition.

Radiation therapy negatively affects patients' nutritional status, which was found to be strongly associated with reduced quality of life (QOL), among patients with head and neck cancer (HNC), according to a study published in Supportive Care in Cancer

Patients with HNC who undergo radiation therapy experience significant adverse events (AEs), including mucositis, xerostomia, dysphagia, and loss of appetite, which commonly results in malnutrition. Although many studies have evaluated the impact of nutrition in cancer patients, investigations in the HNC population are limited. 

  

For this prospective study, researchers enrolled 54 patients undergoing radiation therapy. Patients were interviewed to assess anthropometric and laboratory parameters, the Patient-Generated Subjective Global Assessment was used to assess nutritional status, RTOG score was used to assess morbidity, and the EORTC Core Quality-of-life questionnaire (QLQ-C30) and HNC module (QLQ-H&N35) were used to assess QOL. Measurements were taken at baseline, at the end of radiotherapy, and at 1 and 3 months after completion of radiotherapy. 

Most patients (90%) were well-nourished at the time of study enrollment, but by the end of radiotherapy 75% were malnourished (P<.001). During radiotherapy, patients had a decrease in food intake, lost approximately 5% of their body weight, lost muscle mass in the mid-arm upper circumference and mid-arm, and had decreased serum protein and albumin levels, which are indicative of malnutrition. 

Patients with oropharyngeal cancers who had advanced disease, had undergone concomitant chemotherapy, and experienced worse toxicity had significantly worse nutritional status. 

Further analyses showed that global QOL was significantly worse among patients who were malnourished. 

The authors concluded that “Nutritional assessment should become an integral component of the care of patients with HNC, and should be carried out during different periods in the trajectory of treatment due to its significant contribution to quality of life. It would be worthwhile studying nutritional needs and interventions more deeply.”

Reference

Citak E, Tulek Z, Uzel O. Nutritional status in patients with head and neck cancer undergoing radiotherapy: a longitudinal study [published online June 24, 2018].Support Care Cancer. doi: 10.1007/s00520-018-4319-6

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