Introduction:
Malnutrition is common in head and neck cancer(HNC) with up to 60% malnourished at diagnosis. This increases on radiotherapy(RT) +/- chemotherapy with a further 10% weight loss widely reported. This study analyses the nutritional status of patients at diagnosis, pre RT and during the post RT period. Materials and Methods: 110 patients received RT over 1 year in 2024.
Data was collected at diagnosis, pre RT, post RT, 3/12 post RT, and 6/12 post RT. Results: Significant weight loss is classed at >5%. Median weight loss from usual weight to pre RT appointment was 0.87%. Median weight loss during RT was 5.96%. 58/110 patients had clinically significant weight loss on RT. 11/62 patients had significant weight loss at 3/12 post RT. At 6/12 post RT 8/27 patients still had significantly lower weight. 26 patients had a PEG and 12 patients required supplementary feeding with 5 late PEG insertions. ]Patients with a PEG had average weight loss of 7.3% on RT, and further 2.7% loss at 3/12 post RT. Weight loss for those requiring supplementary NG feeding was 11.7%.
Conclusion:
Significant weight loss is occurring on RT and in the post RT recovery period in HNC patients concurring with published studies. Nutritional screening at diagnosis and rapid access to dietetic intervention is crucial for these patients. MDT discussion of PEG insertion, reactive feeding, introduction of prehabilitation and long term dietetic support post RT are essential.