P348 - NUTRITIONAL SUPPORT IN HEAD AND NECK CANCER PATIENTS UNDERGOING RADIOTHERAPY: A PROSPECTIVE OBSERVATIONAL STUDY

P348

NUTRITIONAL SUPPORT IN HEAD AND NECK CANCER PATIENTS UNDERGOING RADIOTHERAPY: A PROSPECTIVE OBSERVATIONAL STUDY

M. Palombaro¹, M. Cintoni^1,*, E. Zoli¹, P. Gabriele¹, E. Rinninella¹, P. C. Raoul¹, G. Egidi¹, I. Romeo¹, G. Del Borrello¹, M. Massaccesi², S. Longo², F. Pastore², A. Gasbarrini³, M. A. Gambacorta², M. C. Mele¹

¹UOC di Nutrizione Clinica, ²UOC Radioterapia Oncologica, ³UOC Medicina Interna, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

Rationale: Malnutrition and cancer-related cachexia are common in head and neck cancer (HNC) patients and are associated with poor clinical outcomes and reduced treatment tolerance. This study evaluated the prevalence of malnutrition and investigate the impact of nutritional parameters on treatment-related toxicities in HNC patients undergoing radiotherapy without indication for enteral nutrition. Moreover, we evaluated the impact of nutritional intervention in these patients.

Methods: This prospective, single-center observational study enrolled adult HNC outpatients undergoing radiotherapy or chemoradiotherapy. Nutritional assessment was performed before the start and at the end of treatment. Nutritional risk was screened using NRS-2002 and malnutrition diagnosed with GLIM criteria. At baseline, each patient received dietary counseling and a personalized nutritional plan. A patient subgroup received weekly monitoring. Clinical endpoints included treatment tolerance, radiotherapy interruption, and body composition changes.

Results: 136 patients were enrolled. Prevalence of malnutrition at baseline was 25.7%. All treatment interruptions occurred in malnourished patients. Poor nutritional parameters correlated with increased toxicity. Despite weight loss, nutritional intervention was effective in maintaining body composition parameters. Patients receiving intensive nutritional follow-up showed less weight loss compared to standard care and improved phase angle at the end of treatment.

Conclusion: Nutritional impairment in HNC patients undergoing radiotherapy remains a major clinical issue. An intensive and individualized nutritional care pathway can significantly improve malnutrition and treatment tolerance.

Disclosure of Interest: None declared