Nutrition impact symptoms in head and neck cancer during radiotherapy: a longitudinal study

BackgroundPatients with head and neck cancer (HNC) receiving radiotherapy (RT) are at a high risk of weight loss (WL) due to a variety of nutrition impact symptoms (NISs).ObjectiveThis prospective observational study aimed to investigate the consecutive changes of NIS during RT and analyzed its impact on body weight.Materials and methodsThe Head and Neck patient Symptom Checklist was adopted to evaluate NIS. NIS, body weight, hemoglobin and lymphocyte of 94 participants were assessed at four time points during RT and the treatment outcomes were assessed at the time of 12 months after the completion of RT. Generalised estimation equations (GEEs) and Kendall's tau-b were used for statistical analysis.ResultsOur study found that pain, taste changes and dry mouth were the most common NIS, reported by >90% of patients and had higher interference scores (more than 85% >2) at the end of RT. The average WL was 4.22 +/- 3.59 kg after treatment, and more than two-thirds of patients (67.02%, 64/94) experienced significant WL of >5%. Lack of energy, vomiting and taste changes impacted WL significantly (p < .05). Taste changes were also associated with hemoglobin and lymphocyte reduction (p = .018, p < .001). WL correlated negatively with tumor response (p = .031).Conclusions and significanceIn patients with HNC, taste changes, pain, dry mouth and vomiting were seen. Nutritional intervention applied as early as the first 10 days of RT could help to change the nutrition status and improve the clinical outcomes.