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01-03-2021 | Nutrition | Original Article

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

Authors: Chia-Yen Hung, Shun-Wen Hsueh, Chang-Hsien Lu, Pei-Hung Chang, Ping-Tsung Chen, Kun-Yun Yeh, Hung-Ming Wang, Ngan-Ming Tsang, Pei-Wei Huang, Yu-Shin Hung, Shu-Chen Chen, Wen-Chi Chou

Published in: Supportive Care in Cancer | Issue 3/2021

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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Title: A prospective nutritional assessment using Mini Nutritional Assessment-short form among patients with head and neck cancer receiving concurrent chemoradiotherapy
Authors: Chia-Yen Hung
Shun-Wen Hsueh
Chang-Hsien Lu
Pei-Hung Chang
Ping-Tsung Chen
Kun-Yun Yeh
Hung-Ming Wang
Ngan-Ming Tsang
Pei-Wei Huang
Yu-Shin Hung
Shu-Chen Chen
Wen-Chi Chou
Publication date: 01-03-2021
Publisher: Springer Berlin Heidelberg
Keywords: Nutrition
Malnutrition
Radiotherapy
Published in: Supportive Care in Cancer / Issue 3/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-020-05634-3

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