2Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara-Türkiye
3Department of Radiation Oncology, Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul-Türkiye
4Department of Radiation Oncology, Kartal Lütfi Kırdar Training and Research Hospital, İstanbul-Türkiye
5Department of Radiation Oncology, Trakya University Faculty of Medicine, Edirne-Türkiye DOI : 10.5505/tjo.2024.4462 OBJECTIVE
Head and neck cancer (HNC) is one of the cancer types with the highest prevalence of malnutrition and, therefore, sarcopenia. In this study, we evaluated whether nutritional support can prevent weight loss and sarcopenia among patients who undergo RT/CRT.
METHODS
A total of 94 head and neck cancer patients who received 5-week RT or CRT with concomitant nutritional
support were included in this study. For each patient, before treatment and at the end of the 5th
week of treatment, C3-level paravertebral muscles were contoured through planning systems. Patient
demographics, PNI, NRI, and NRS-2002 scores, as well as height, weight, and body mass index, were
also evaluated.
RESULTS
At the end of 5 weeks, there was a significant loss in the patients" weight z-score and BMI (p<0.001 and
p<0.001, respectively). The decrease in C3-level paravertebral muscle volume of patients with high PNI
values was also observed to be high between the 1st and 5th weeks (p=0.037), and there was no connection
between NRI and muscle volume (p=0.301). No correlation was observed between the patients" weight
z-score, BMI, and PNI or NRI values between the 1st and 5th weeks (p>0.066 and p>0.210, respectively). A
significant decrease was observed in C3-level paravertebral muscle volume over a 5-week period (p<0.001).
CONCLUSION
In our study, nutritional intervention did not prevent patients from losing weight and caused decreases in
BMI, regardless of head and neck cancer type, stage, and risk score, during the 5-week follow-up. There
was no correlation between the nutritional risk score (NRS), the prognostic nutritional index (PNI), and
muscle volume. Even on occasions when BMI has not changed, occult sarcopenia and muscle loss should
not be overlooked. However, more accurate results will be obtained with a longer-term follow-up.