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A prospective nutritional assessment using Mini Nutritional Assessment-short form among patients with head and neck cancer receiving concurrent chemoradiotherapy

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Abstract

Background

No gold standard of nutritional assessment is established among patients with head and neck cancer (HNC) receiving concurrent chemoradiotherapy (CCRT). This study aimed to evaluate the clinical significance of pre-treatment nutritional status using the Mini Nutritional Assessment-short form (MNA-SF) among HNC patients receiving CCRT.

Methods

A total of 461 consecutive patients with newly diagnosed HNC treated with definitive CCRT at three medical institutes were prospectively enrolled. Nutritional status was assessed using MNA-SF within 7 days before CCRT initiation. Patients were classified as having normal nutrition, at risk of malnutrition, and malnourished groups according to MNA-SF for comparison.

Results

The 1-year overall survival rates were 89.8%, 76.8%, and 67.7% in the normal nutrition, at risk of malnutrition, and malnourished groups, respectively. Patients with normal nutrition had significantly lower rates of uncompleted radiotherapy and chemotherapy (4.5% and 4.1%, respectively) compared with patients at risk for malnutrition (14.1% and 11.5%, respectively) and those malnourished (11.1% and 11.1%, respectively). Patients with normal nutrition had significantly lower treatment-related complication rates regarding emergency room visits, hospital admission, and need for tubal feeding than those with at risk of malnutrition and malnourished. Patients with normal nutrition had significantly fewer severe hematologic toxicities (p = 0.044) and severe non-hematologic toxicities (p = 0.012) of CCRT than those malnourished.

Conclusion

Pre-CCRT nutritional status identifies HNC patients vulnerable to treatment interruption and treatment complications. We suggest that nutritional assessment with MNA-SF should be incorporated in pre-CCRT evaluation for all HNC patients.

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Acknowledgments

The authors gratefully acknowledge Miss Vengi Ho and the support from the Cancer Center of Chang Gung Memorial Hospital, Taoyuan, Taiwan.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Chang Gung Memorial Hospital, 5 Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan

    Chia-Yen Hung, Hung-Ming Wang, Pei-Wei Huang, Yu-Shin Hung & Wen-Chi Chou

  2. Division of Hema-oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan

    Chia-Yen Hung

  3. Department of Oncology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan

    Shun-Wen Hsueh, Pei-Hung Chang & Kun-Yun Yeh

  4. Department of Oncology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan

    Chang-Hsien Lu & Ping-Tsung Chen

  5. Department of Radiation Oncology, Chang Gung University, Taoyuan, Taiwan

    Ngan-Ming Tsang

  6. Cancer Registry Center, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Shu-Chen Chen

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  1. Chia-Yen Hung
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Correspondence to Wen-Chi Chou.

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The study protocol was approved by the institutional review board at all study sites (no. 1608080002).

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Hung, CY., Hsueh, SW., Lu, CH. et al. A prospective nutritional assessment using Mini Nutritional Assessment-short form among patients with head and neck cancer receiving concurrent chemoradiotherapy. Support Care Cancer 29, 1509–1518 (2021). https://doi.org/10.1007/s00520-020-05634-3

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