Nutritional status in patients with head and neck cancer undergoing radiotherapy: a longitudinal study.

PURPOSE: Patients with head and neck cancers are susceptible to malnutrition during radiotherapy. This study aimed to determine the changes in the nutritional status and its determinants in patients with head and neck cancer during radiotherapy. METHODS: This prospective observational study was performed in an outpatient Radiation Oncology clinic with a sample of 54 patients. An interview form (including anthropometric and laboratory parameters), the Patient-Generated Subjective Global Assessment to assess nutritional status, quality of life scales, and toxicity criteria were used for data collection at the baseline, the end of radiotherapy and 1 and 3 months after radiotherapy. RESULTS: While the majority of the patients (90%) were well nourished at baseline, most of the patients (74%) were malnourished at the end of radiotherapy (p < 0.001). During radiotherapy, patients developed malnutrition, reflected in a decrease in food intake, approximately 5% loss of body weight, a reduction in mid-arm upper circumference and mid-arm muscle mass, and reduced serum protein and albumin levels. The nutritional status was worse in oropharyngeal cancers (p = 0.021), advanced stage (p = 0.004), use of concomitant chemotherapy (p = 0.041), and worse toxicity (p < 0.001). Furthermore, the nutritional status was strongly associated with the quality of life. CONCLUSIONS: This study demonstrated negative impact of radiotherapy on the nutritional status of patients with head and neck cancer. The study also showed the association of the nutritional status and the quality of life. The nutritional status should be assessed during different periods in the trajectory of treatment due to its significant contribution to the quality of life.

Longitudinal quality of life in Turkish patients with head and neck cancer undergoing radiotherapy.

PURPOSE: This study aims to assess the quality of life and to define its determinants in patients with head and neck cancer undergoing radiotherapy. METHOD: This prospective study was performed in an outpatient clinic of radiation oncology with a sample of 54 consecutive patients. Interview forms-European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire and Head and Neck Module to measure quality of life, Radiation Therapy Oncology Group criteria to determine radiation toxicity, and Patient-Generated Subjective Global Assessment to assess nutritional status-were used to obtain personal and disease-related data before, at the end of radiotherapy, and 1 and 3 months post-therapy. RESULTS: It was determined that various subscales of functional and symptom scales of quality of life were deteriorated at the end of radiotherapy and started to improve at 1 month after treatment. However, dry mouth and sticky saliva symptom scales did not follow the same pattern, and they took more time to improve. Quality of life (QoL) was found to be worse in younger age, higher education, higher income level, type of cancer, advanced stage, presence of tracheostomy, chemoradiation, higher dose of RT, bad nutritional status, and radiation toxicity. CONCLUSIONS: Our results emphasize the vital need of support for head and neck cancer patients during radiotherapy, especially during the first month.