title: [Evaluation of a predictive score for malnutrition in patients treated by irradiation for head and neck cancer: a retrospective study in 127 patients].
abstract: OBJECTIVE
  The purpose of this study was to establish a pre-therapeutic score that could predict which patients would be at high risk of enteral tube feeding during (chemo)-radiotherapy for head and neck cancer.
  
  
  METHODS
  A monocentric study was conducted retrospectively on patients receiving a radiotherapy or concurrent chemoradiotherapy for a head and neck cancer. A logistic model was performed in order to assess clinical or therapeutic risk factors for required artificial nutrition during treatment. Significant parameters, issued from multivariate analysis, were summed and weighted in a score aiming at estimating a malnutrition risk during radiotherapy.
  
  
  RESULTS
  Among the 127 evaluated patients, 59 patients required artificial nutrition during radiotherapy. In multivariate analysis, predictive factors for malnutrition were weight loss superior to 5% in the 3 months before radiotherapy, advanced tumor stage (III-IV vs. I-II), and pain requiring strong analgesics (step II-III vs. I). Concurrent chemotherapy was identified as a significant risk factor also, but it was strongly correlated with the tumor stage. The score, estimated from these previous factors, allowed a prediction of a risk of enteral feeding with a sensitivity of 90% and a specificity of 85%.
  
  
  CONCLUSIONS
  A predictive score of enteral nutrition before radiotherapy of head and neck cancer should be a useful clinical tool to target the patients who would need a prophylactic gastrostomy. Our study evidenced some risk factors of malnutrition requiring artificial feeding. However, we need a prospective study to confirm the validity of this score.
authors.affiliation: Service d'oncologie-radiothérapie, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France. Electronic address: lescut.nicolas@hotmail.fr.
authors.forename: N
authors.initials: N
authors.lastname: Lescut
authors.forename: E
authors.initials: E
authors.lastname: Personeni
authors.forename: M
authors.initials: M
authors.lastname: Desmarets
authors.forename: M
authors.initials: M
authors.lastname: Puyraveau
authors.forename: R
authors.initials: R
authors.lastname: Hamlaoui
authors.forename: S
authors.initials: S
authors.lastname: Servagi-Vernat
authors.forename: J-F
authors.initials: JF
authors.lastname: Bosset
authors.forename: F
authors.initials: F
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000453:epidemiology; D000701:Analgesics, Opioid / Q000627:therapeutic use; D059248:Chemoradiotherapy; D005260:Female; D005774:Gastrostomy; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D009367:Neoplasm Staging; D018529:Nutritional Support; D010146:Pain / Q000188:drug therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015431:Weight Loss; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: Head and neck; Nutrition; Radiotherapy; Radiothérapie; Voies aérodigestives supérieures