Nutrition outcomes and treatment toxicities in patients with head and neck cancer receiving helical intensity-modulated radiotherapy.

Claire Blake, Rainbow Lai, Teresa Brown, Anita Pelecanos, Laura Moroney, Jennifer Helios, David Smith, Brett G M Hughes, Lizbeth Kenny, Benjamin Chua, Judith Bauer

Journal: Journal of human nutrition and dietetics : the official journal of the British Dietetic Association 2024;37(1):182-192

PMID: 37737485

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Abstract

BACKGROUND

Helical intensity-modulated radiotherapy (H-IMRT) provides excellent limitation of dose to tissues not requiring treatment, although acute toxicity still occurs. The present study aimed to determine how treatment-related acute toxicities affect nutrition outcomes in patients with head and neck cancer.

METHODS

A prospective observational study was conducted in 194 patients undergoing curative intent H-IMRT with or without other treatment modalities. Weight outcomes (kg) and acute toxicity and dysphagia data were collected during treatment using Common Toxicity Criteria for Adverse Effects (CTCAE), version 4.0.

RESULTS

Significant weight loss (> 10%) was observed in 30% of high nutritional risk patients and 7% of low nutritional risk patients. Nausea, adjusted for baseline dysphagia, in high nutritional risk patients and nausea, dysphagia and pharyngeal mucositis in low nutritional risk patients were significant factors in explaining the percentage loss in baseline weight to treatment completion.

CONCLUSIONS

Significant weight loss remains an issue during treatment, despite improvements in radiotherapy technology and high-level multidisciplinary care.

Address: Metro North Hospital and Health Service, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia.; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.; QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.; School of Health & Rehabilitation Sci, Brisbane, QLD, Australia.; Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.; Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, VIC, Australia.

DOI: 10.1111/jhn.13243

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MeSH Terms: Humans, Radiotherapy, Intensity-Modulated, Deglutition Disorders, Head and Neck Neoplasms, Weight Loss, Nausea