Prevalence and influence of malnutrition on quality of life and performance status in patients with locally advanced head and neck cancer before treatment.
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.
Capuano
Giorgio
G
Clinical Nutrition Unit, Ospedale San Pietro-Fatebenefratelli, Via Cassia, 600-00189 Rome, Italy. giorgio.capuano@fastwebnet.it
Gentile
Pier Carlo
PC
Bianciardi
Federico
F
Tosti
Michela
M
Palladino
Anna
A
Di Palma
Mario
M
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