Nutrition Status and Health‐Related Quality of Life Among Outpatients With Advanced Head and Neck Cancer

Abstract

This pilot study evaluated nutrition status and health-related quality of life (HRQOL) outcomes among outpatients with head and neck cancer (HNC). Data were collected from 19 patients (18 males, 1 female) during 3 time points: once before chemoradiotherapy (CRT) initiation and 1 and 3 months after CRT. Nutrition status was evaluated using the Scored Patient-Generated Subjective Global Assessment (PG-SGA). Malnutrition was defined as PG-SGA stage B (moderate/suspected malnutrition) or stage C (severely malnourished). HRQOL was assessed through the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its HNC-specific module (QLQ-H&N35). We found that well-nourished patients reported having fewer issues with pain, fatigue, appetite loss, chewing, sticky saliva, coughing, and social eating than those categorized as malnourished (P < .05). The association between the global quality-of-life score and PG-SGA score was statistically significant but weak in strength (r = −0.37, P = .012). Although PG-SGA identified 70% as either moderately or severely malnourished before treatment initiation, the mean body mass index was in the overweight category (29 ± 5 kg/m 2). Compared with pretreatment, patients reported more severe problems with chewing, swallowing, sticky saliva, dry mouth, speech, social eating, and taste and smell sensations at 1-month follow-up, although issues with dry mouth persisted 3 months post treatment (P = .003). In conclusion, malnourished patients reported having worse HRQOL symptoms compared with well-nourished patients. Routine nutrition and psychosocial assessment through PG-SGA and EORTC tools might help identify patients in need of nutrition and psychosocial care.

Mapping Health-Related Quality of Life, Anxiety, and Depression in Patients with Head and Neck Cancer Diagnosed with Malnutrition Defined by GLIM

“…For the group in total, the mean values of HRQoL scores were in general most severe at this time point. For patients treated with RT, this is the time point when the systematic daily support from the healthcare system during treatment ends, i.e., at a time point when nutritional status [ 16 , 17 ] and HRQoL [ 22 , 23 ] often are at their worse. This indicates the importance of extra support to the patients when returning home after treatment.…”

Impact of sarcopenia on acute radiation-induced toxicity in head and neck cancer patients

“…HNC patients have a high-risk of malnutrition due to impairment in swallowing and the passage of food due to tumour and treatment-related toxicity [8]. In general, around 70% of HNC patients are identified as either moderately or severely malnourished before treatment initiation [9]. Malnutrition has proved to be a strong predictor of sarcopenia since it is correlated with an approximately fourfold higher risk of developing sarcopenia [10].…”

Blenderized Food Tube Feeding for Radioactive Iodine Ablation

“…26 Patients with head and neck cancer (HNC) are at a high risk for malnutrition and nutrient deficiencies during all phases of illness, due to dysphagia related to tumor burden, increased metabolic needs, and treatmentrelated toxicities such as odynophagia, dysphagia, dysgeusia, mucositis, fibrosis, xerostomia, anorexia, difficulty chewing, and nausea and vomiting. [27][28][29] Approximately 35% to 60% of HNC patients are malnourished at time of diagnosis. 29 Patients with gastrointestinal cancer represent another group that is at a high risk for malnutrition due to tumor burden, the catabolic disease process, alterations to food digestion and nutrient absorption, treatment-related toxicities, and surgical intervention exacerbating these difficulties.…”

“…[27][28][29] Approximately 35% to 60% of HNC patients are malnourished at time of diagnosis. 29 Patients with gastrointestinal cancer represent another group that is at a high risk for malnutrition due to tumor burden, the catabolic disease process, alterations to food digestion and nutrient absorption, treatment-related toxicities, and surgical intervention exacerbating these difficulties. 30 Although there is limited research on BTF in oncology patients, 31 the scant but promising research on BTF in other patient populations has sparked interest in exploring safety and efficacy of real food tube feeding in enterally fed oncology patients.…”