title: Prevalence and influence of malnutrition on quality of life and performance status in patients with locally advanced head and neck cancer before treatment.
abstract: OBJECTIVE
  The aim of this study was to evaluate the prevalence and influence of malnutrition (unintentional weight loss >or=5% in the last 3 months) on quality of life (QoL) and performance status (PS) in head and neck cancer patients (HNC) before treatment.
  
  
  METHODS
  Sixty-one consecutive outpatients affected by locally advanced HNC (III-IVA stage) were enrolled. In all patients, nutritional intake (by diet history), nutritional status (Patient Generated Subjective Global Assessment), unintentional weight loss (UWL), serum prealbumin, hemoglobin level (Hb), C-reactive protein, QoL (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30 v. 3.0), and PS (Eastern Cooperative Oncology Group (ECOG) PS) were assessed before radio or concomitant chemoradiotherapy.
  
  
  RESULTS
  Thirty-six percent of HNC were malnourished before treatment. The median ECOG PS in malnourished patients was 1 (0-2), whereas in nonmalnourished was 0 (0-2; p = 0.018). Physical (p = 0.043), role (p = 0.047), and social functions (p = 0.024) scores were significantly worse in malnourished than in nonmalnourished HNC. Fatigue (p < 0.001), appetite loss (p < 0.001), and nausea and vomiting (p = 0.002) scores were worse in malnourished patients than in nonmalnourished. In the multivariate analysis, UWL and Hb level independently influenced physical (p = 0.002; p = 0.005), role (p = 0.004; p = 0.001), and social functions (p = 0.024; p = 0.009).
  
  
  CONCLUSIONS
  Our data suggest that an early and intensive nutritional support might reduce weight loss before, during, and after treatment completion, improving outcome, QoL, and PS.
authors: Clinical Nutrition Unit, Ospedale San Pietro-Fatebenefratelli, Via Cassia, 600-00189 Rome, Italy. giorgio.capuano@fastwebnet.it
authors: Giorgio
authors: G
authors: Capuano
authors: Pier Carlo
authors: PC
authors: Gentile
authors: Federico
authors: F
authors: Bianciardi
authors: Michela
authors: M
authors: Tosti
authors: Anna
authors: A
authors: Palladino
authors: Mario
authors: M
authors: Di Palma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000855:Anorexia / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009325:Nausea / Q000209:etiology; D009367:Neoplasm Staging; D018529:Nutritional Support / Q000379:methods*; D015995:Prevalence; D011788:Quality of Life; D012720:Severity of Illness Index; D014839:Vomiting / Q000209:etiology; D055815:Young Adult