Longitudinal observations of the prevalence of nutritional risk and undernutrition in patients with head and neck cancer during radiotherapy

Abstract

Objective To investigate the changes in prevalence of nutritional risk and undernutrition in patients with head and neck cancer during radiotherapy. Methods In this longitudinal observational study, a convenience sampling method was used to recruit patients with head and neck cancer who were receiving radiotherapy in Beijing Cancer Hospital. Nutritional Risk Screening 2002 (NRS 2002) was applied to assess the prevalence of nutritional risk in the patients, and Patient-Generated Subjective Global Assessment (PG-SGA) and body composition test to determine the prevalence of malnutrition (undernutrition) before, during and after radiotherapy. Results 56 patients finished the three follow-up exams. Along with the progress of radiotherapy, the scores of NRS 2002 increased gradually (1.64±1.09 vs. 2.30±1.06 vs. 3.14±1.07, χ2=46.639, P<0.001), and the prevalence of nutritional risk also increased gradually (21.43% vs. 37.50% vs. 71.43%, χ2=29.700, P<0.001); the total scores of PG-SGA [1 (1-13) vs. 6 (1-15) vs. 12 (1-18), χ2=63.206, P<0.001] and dimensions of weight [0 (0-4) vs. 1 (0-4) vs. 3 (0-6), χ2=40.798, P<0.001], intake [0 (0-2) vs. 1 (0-2) vs. 2 (0-4), χ2=64.707, P<0.001] and symptoms[0 (0-7) vs. 2 (0-10) vs. 6 (0-11), χ2=61.562, P<0.001] all increased gradually with statistical significance. The prevalence of malnutrition in different stage of radiotherapy were significantly different (χ2=64.999, P<0.001). The body composition analysis in 40 patients showed that all the indicators of body composition decreased significantly along with the progress of radiotherapy. There was a great loss in patients' body weight during radiotherapy, especially the fat-free mass. Conclusions The prevalence of nutritional risk and undernutrition may increase in patients with head and neck cancer during radiotherapy. Lean body mass accounted for most of the weight loss. We should pay more attention to those patients' nutritional status during radiotherapy. Key words: Head and neck neoplasms; Radiotherapy; Nutritional status; Nutritional risk