Effect of nutritional status before radiotherapy on radiation‐induced acute toxicities in patients with nasopharyngeal carcinoma

Abstract

Background To investigate the effect of nutritional status on radiation‐induced acute toxicities in nasopharyngeal carcinoma (NPC) patients before radiotherapy. Methods Nutritional status of 228 patients with NPC who received intensity‐modulated radiotherapy was retrospectively analyzed by modified nutrition index (m‐NI). Cumulative grading score of six common acute toxicities were defined as total score for acute toxicities. Results M‐NI ≤6 is a risk factor for xerostomia (p = 0.016, OR = 0.208, 95% CI 0.058–0.743), oral mucositis (p = 0.016, OR = 0.287, 95% CI 0.104–0.793), dysgeusia (p = 0.001, OR = 0.028, 95% CI 0.004–0.217), and dysphagia (p = 0.015, OR = 0.251, 95% CI 0.083–0.764) as well in patients with NPC. Total score of radiation‐induced acute toxicities of patients with malnutrition (13.6 ± 1.7) was significantly higher than that of patients with normal nutrition (12.0 ± 2.4) (t = −5.464, p < 0.001). Conclusions NPC patients with malnutrition before radiotherapy develop more serious dysgeusia, oral mucositis, dysphagia, and xerostomia after intensity‐modulated radiotherapy.

May Nutritional Status Positively Affect Disease Progression and Prognosis in Patients with Esophageal and Pharyngeal Cancers? A Scoping Review of the Current Clinical Studies

“…Severe nutritional impairment during IMRT, which was assessed as a reduction in m-NI score of ≥50%, was independently associated with overall patients’ survival and oral mucositis [ 64 ]. Similarly, the recent survey by Song et al (2023) demonstrated that malnutrition before radiotherapy, assessed via m-NI, was a predictor of short-term clinical complications such as severe dysgeusia, oral mucositis, dysphagia, and xerostomia next to radiotherapy for nasopharyngeal cancer, which, in turn, worsen patients’ nutritional statuses [ 65 ]. Regarding overall survival, the follow-up survey of Hong et al (2017) on 323 individuals with nasopharyngeal carcinoma who underwent intensity-modulated radiotherapy indicated that the m-NI was a substantial prognosticator for 1, 3, and 5 year overall survival in this patient group [ 66 ].…”

“…Song 2023 [65] 323 patients with nasopharyngeal carcinoma undergoing intensity-modulated radiotherapy modified Nutrition Index…”

May Nutritional Status Positively Affect Disease Progression and Prognosis in Patients with Oesophageal and Pharyngeal Cancers? A Scoping Review of the Current Clinical Studies

“…Severe nutritional impairment during IMRT, which was assessed as a reduction in m-NI score of ≥ 50%, was an independent prognosticator for overall patients' survival and oral mucositis [60]. Similarly, the recent survey by Song et al (2023) demonstrated that malnutrition before radiotherapy, assessed via m-NI, was a predictor of short-term clinical complications such as severe dysgeusia, oral mucositis, dysphagia, and xerostomia next to radiotherapy for nasopharyngeal cancer, which in turn worsen patients' nutritional status [61]. Regarding overall survival, the prospective study by Hong et al (2017) on 323 nasopharyngeal cancer patients undergone intensitymodulated radiotherapy indicated that the m-NI was a substantial prognosticator for 1-, 3-, and 5year overall survival in this patient group [62].…”

“…Song 2023 [61] 323 patients with nasopharyngeal carcinoma undergoing intensitymodulated radiotherapy modified Nutrition Index…”