Nutrition and head-neck cancer: A prospective observational study in patients with head neck cancer receiving adjuvant/definitive radiotherapy/chemoradiotherapy.

Abstract

e18784 Background: Head-Neck cancers are at higher risk of malnutrition due to their disease or its treatment which can cause structural changes to the oral cavity and prevent effective nutrition. Malnutrition is assessed by anthropometric measurements. Skeletal muscle strength is also a marker of nutrition. The present study aimed to study the correlation between nutrition, muscle strength and acute toxicities in patients with head and neck squamous carcinoma receiving concurrent chemoradiotherapy or radiotherapy alone. Methods: A prospective observational study was conducted at Deenanath Mangeshkar Hospital, Pune, India in patients with nonmetastatic head neck squamous cancers planned for definitive or adjuvant chemo-radiotherapy. Nutritional status was assessed at baseline, end of treatment and after 3months of treatment by mid-arm circumference, weight, height and body mass index. Muscle strength was assessed by Jamar’s handgrip dynamometer. Results: A total of 103 patients (85 males and 18 females) participated in the study between February 2020 and February 2021. Four patients had to be withdrawn before initiating treatment, 99 patients completed the planned course of treatment. Mean age was 54.4 years. Postoperative chemoradiotherapy was give to 37 patients, 22 received definitive chemoradiotherapy, 33 received postoperative radiotherapy alone and 7 patients received definitive radiotherapy. A statistically significant reduction in all nutritional parameters during treatment and at 3 months after completion of treatment was seen. Mucositis and odynophagia were the commonest toxicities. Nasogastric or percutaneous gastrostomy tube was inserted in 25 patients. Seven patients required hospitalisation for toxicities. There were no treatment related deaths. Conclusions: Head and neck cancer patients undergoing concurrent chemoradiation or radiation are at significantly higher risk of malnutrition. Loss of muscle strength correlates with treatment related acute toxicity. [Table: see text]