The reliable predictors of severe weight loss during the radiotherapy of Head and Neck Cancer

Efficacy of the Nutritional Risk Index, Geriatric Nutritional Risk Index, BMI, and GLIM-Defined Malnutrition in Predicting Survival of Patients with Head and Neck Cancer Patients Qualified for Home Enteral Nutrition

“…Our results suggest that BMI value, which is commonly used in clinical practice, is a weak tool for predicting survival of analyzed group of patients. Similar results, suggesting that BMI cannot be considered as a predictor without an assessment of body composition were reported by Nazari et al [ 18 ]. GLIM-defined malnutrition, NRI and GNRI indices are better in assessing patient prognosis.…”

Concurrent Chemoradiotherapy Induces Body Composition Changes in Locally Advanced Head and Neck Squamous Cell Carcinoma: Comparison between Oral Cavity and Non-Oral Cavity Cancer

“…In addition to daily calorie intake during CCRT, certain treatment-associated grade ¾ toxicities may intensify LBM or TFM loss [ 45 ]. Our data showed that patients in the OCC subgroup who developed grade ¾ toxicity with either anemia or neutropenia lost more fat mass, and those in the NOCC with grade ¾ mucositis lost more muscle mass ( Table 3 and Table 4 ; Figure 4 ).…”

“…Although LBM loss accounts for over 70% BW loss in patients with LAHNSCC during CCRT, most studies have explored the predictive effects of both age and BMI on BW loss rather than on LBM loss; however, the results regarding BW loss prediction have been conflicting [ 17 , 45 , 47 , 48 , 49 ]. From our own perspective, these inconsistent observations could be ascribed to retrospective design, enrollment heterogeneity (variations in tumor stage, mixed head and neck cancer entities, and treatment modalities), the preference for tube feeding from patients and healthcare professionals, the classification of aging and BMI by different ranges, and lack of comprehensive risk factor analysis.…”

Nutritional Deficiencies in Radiotherapy-Treated Head and Neck Cancer Patients

“…Assessment of the risk of cancer malnutrition, sarcopenia or cachexia at the stage of RT planning in HNC patients seems to be crucial for determining the patient's further prognosis, the success of the applied therapy, and the risk of early and long-term effects of its toxicity [88]. The currently available predictive tools-the patient's clinical features (age, smoking, and socioeconomic status), anthropometric measures (body weight, and BMI), clinical scales (Nutritional Risk Score-NRS-2002), or laboratory tests (markers of inflammation and the albumin level)-are insufficient for predicting the development of malnutrition during RT [54,67,81,[89][90][91]. The more reliable tools for the prediction of RTinduced changes in body composition demonstrate parameters derived from BIA, mainly the phase angle (PA), whose value is decreased in malnourished/cachectic patients [92].…”

“…Phase angle (PA) [52] The risk of malnutrition/cachexia developing during CRT increased by 1.71 per mean PA decrease by one unit PA [92] Patients with low PA had 9.3-fold higher chance of BMI reduction below 18.5 kg/m 2 and over 5.9-fold and 4.2-fold higher chance of lean mass (LM) and FM reduction after therapy end compared with patients with a high PA value pre-albumin [81] Decrease of > 15% in pre-albumin level was more likely to be malnourished (OR = 2.442) after RT commencement. Pre-albumin level predicts weight loss during RT pre-albumin [83] The percentage of weight loss during RT negatively correlated with pre-albumin concentration, but not with other nutrition parameters 3-hydroxybutyrate (3HB) [102] 3HB is a relatively sensitive marker that allows earlier identification of the HNC at higher risk of > 10% weight loss during RT/CRT TNF-α−1031T/C [103] Patients with CC genotype had a significantly higher chance of BMI decrease < 18.5 kg/m 2 (underweight) following RT (OR = 23.0) and lower total protein and albumin concentration in the blood compared to carriers of CT and TT genotypes SELP-2028 C/T [104] The chance of losing ≥ 10% body weight and the development of cachexia during radical RT in patients with CC and CT genotypes was five times higher than TT genotype carriers (OR = 5.0)…”