Monitoring nutritional status during radiotherapy in patients with head and neck cancer

Abstract

Objective: Head and neck cancers are associated with a high risk of malnutrition due to effects on swallow ing and respiratory functions. Treatments such as surgery, radiotherapy, and chemotherapy may reduce oral intake, increasing malnutrition risk and negatively affecting nutritional status and quality of life. This study aims to monitor nutritional status patients with head and neck cancer during radiotherapy and evaluate relationship with clinical findings, quality of life, and treatment-related side effects. Materials-Methods: The study was conducted at the Radiation Oncology Clinic of Marmara University Pen dik Training and Research Hospital between July 2025 and March 2026. Body composition measurements were obtained using Bioelectrical Impedance Analysis (BIA). Malnutrition risk was assessed with the Pa tient-Generated Subjective Global Assessment (PG-SGA) and NutriScore; quality of life with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ); and treat ment-related side effects with the Common Terminology Criteria for Adverse Events (CTCAE). Measurements were performed during the 6-week radiotherapy period, and data were analyzed using SPSS 28.0 with a significance level of p < 0.05. Results: A total of 14 patients were included in the study (age: 63.4 ± 12.1 years; 21.4% female, 78.6% male). All patients received radiotherapy, and 57.1% were treated with concurrent chemotherapy. After six weeks, a statistically significant decrease was observed in body weight and BMI (Body Mass Index) (p < 0.001 for both), while PG-SGA total scores significantly increased (p = 0.002). NutriScore scores increased but were not statistically significant (p = 0.054). EORTC QLQ-C30 global health status scores significantly decreased (p = 0.018). According to CTCAE evaluation, the severity of dysphagia, taste alterations, and fatigue significantly increased (p < 0.05), whereas no significant changes were observed in other toxicities. In anthropometric and body composition analyses, waist circumference and mid-upper arm circumference remained unchanged, while hip circumference significantly decreased (p = 0.012). Fat mass decreased without statistical signifi cance, whereas fat-free mass (p = 0.002) and total body water (p = 0.002) showed significant reductions. Conclusion(s): During the six-week follow-up period, deterioration in nutritional status, a decrease in quality of life, and an increase in some treatment-related toxicities were observed in patients receiving radiotherapy. These findings highlight the importance of regularly assessing the nutritional status of patients during the radiotherapy process and implementing early nutritional interventions.