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Prognostic value of nutritional impairment on treatment‐related toxicity and survival in patients with nasopharyngeal carcinoma taking normal nutrition before radiotherapy
Author(s) -
Su Li,
Lin Qiaojing,
Li Rong,
Hua Yangjingling,
Zhang Hairong,
Song Xiurong,
Ye Jinru,
Zhang Weijian,
Hong Jinsheng
Publication year - 2020
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26426
Subject(s) - mucositis , medicine , nasopharyngeal carcinoma , gastroenterology , radiation therapy , risk factor , body mass index , toxicity , oncology , surgery
Background To investigate nutritional impairment during intensity‐modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC) taking normal nutrition before IMRT and its effect on treatment‐related toxicities (TRTs) and survival. Methods Modified nutrition index (m‐NI) of 187 patients with NPC, comprised eight indicators (body mass index, circumference of upper arm muscles, total lymphocyte count, red blood cell count, levels of albumin, pre‐albumin, transferrin, and hemoglobin), were evaluated before/after IMRT. Patient characteristics, m‐NI, and the follow‐up data for survival and TRTs were analyzed. Results The m‐NI scores of patients with NPC decreased significantly after IMRT. Severe nutritional impairment (SNI; decrease in m‐NI score ≥50%) was an independent prognostic factor for overall survival (OS) and an independent risk factor for grade ≥2 oral mucositis. Classification T4 disease and smoking were SNI risk factors. Conclusions SNI during IMRT is a risk factor for oral mucositis and a prognostic factor for worse OS in patients with NPC.