Evaluating Nutritional Health in Cases of Head and Neck Cancer Receiving Radiotherapy

Introduction Patients diagnosed with head and neck cancers (HNC) are highly susceptible to malnutrition, with initial rates ranging from 35% to 60%, which can further worsen during treatment, leading to significant weight loss in up to 80% of patients. Malnutrition often remains undetected, contributing to increased morbidity, mortality, and healthcare expenses. This study sought to evaluate the nutritional status of patients with head and neck cancer receiving radiotherapy and investigate its relationship with factors related to the disease and treatment.  Materials and Methods The study is a longitudinal observational research involving 31 patients who were treated at the Radiation Oncology Unit of the National Institute of Oncology in Rabat, Morocco, between October 2023 and March 2024. Patients underwent radiation therapy using the Volumetric Modulated Arc Therapy (VMAT) technique, either alone or in combination with chemotherapy. Data, including anthropometric measurements, PG- SGA assessments, and RTOG criteria evaluations, were gathered at the start of treatment, at the end of treatment, and three months after the treatment ended.  Results The cohort consisted of 28 males and 3 females, with a mean age of 56 ± 8 years. The majority of tumors were located in the larynx (32%) and nasopharynx (30%), with 78% of patients presenting with stage III or IV cancer. Initially, 88% of patients were well- nourished; however, by the end of treatment, 79% were malnourished. The average PG-SGA score rose from 2.8 to 11.3. There was a marked decrease in food intake, with only 40.2% of patients consuming more than half of their meal portions by the end of treatment. Weight loss occurred in 85% of patients, with 27% experiencing a loss of over 10% of their initial body weight. Patients with advanced-stage cancer, oral cavity and pharyngeal cancers, and those undergoing chemo-radiotherapy were more likely to be malnourished. Higher radiation doses were associated with increased pain and swallowing difficulties.  Conclusion Radiotherapy significantly worsens the nutritional status of HNC patients, particularly by the end of treatment. The most severe nutritional declines were observed in patients with oral cavity and pharyngeal cancers, advanced-stage disease, concurrent chemotherapy, and higher radiation toxicity. Incorporating routine nutritional assessments into clinical practice and assigning dedicated staff for these evaluations could enable timely nutritional interventions.