PD713 - MALNUTRITION IN PATIENTS WITH ADVANCED HEAD AND NECK CANCER:EXPLORING THE GLIM CRITERIA, ENERGY BALANCE AND HEALTH-RELATED QUALITY OF LIFE

Linked sessions

PD713

MALNUTRITION IN PATIENTS WITH ADVANCED HEAD AND NECK CANCER:

EXPLORING THE GLIM CRITERIA, ENERGY BALANCE AND HEALTH-RELATED QUALITY OF LIFE

C. Wallmander1,2,*, I. Bosaeus3,4, E. Silander1,2, M. Berg1,2, H. Haugen Cange5,6, J. Nyman5,6, E. Hammerlid1,2

1Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, 2Department of Otorhinolaryngology-Head and Neck Surgery, Region Västra Götaland, Sahlgrenska University Hospital, 3Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, 4Department of Clinical Nutrition, Region Västra Götaland, Sahlgrenska University Hospital, 5Department of Oncology, Institute of Clinical Sciences, 6Department of Oncology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden

 

Rationale: Head and neck cancer (HNC) is associated with a high risk of malnutrition due to tumor- and treatment-related side effects. This study aimed to assess malnutrition using the GLIM criteria, explore the different GLIM combinations, examine changes in body composition and body energy content, and evaluate HRQoL in patients with locally advanced HNC.

Methods: Malnutrition was diagnosed using the GLIM criteria; appendicular lean soft tissue (ALST) and body fat were estimated using dual-energy X-ray absorptiometry (DXA), and body energy content was calculated. CRP levels, energy intake and use of enteral or parenteral nutrition were assessed. HRQoL was evaluated using the EORTC QLQ-C30 and QLQ-HN35, and MDADI. Patients were assessed at baseline, 6 weeks and at 3, 6 and 12 months after treatment initiation. 

Results: Eighty patients were included. Malnutrition prevalence varied over time and peaked at the end of treatment (71%), with weight loss, reduced food intake and inflammation as the most common combination (31%). At the end of treatment patients had a negative energy balance, with reductions in body weight (6%), body fat (6%) and ALST (8%). At 3 months, muscle loss had ceased, and patients began to regain muscle mass, while body fat continued to decline. Patients with malnutrition reported worse HRQoL at all time points, except at the end of treatment, when no significant differences were observed between groups.

Image:



 

Conclusion: Patients with advanced HNC receiving combination treatment experienced major nutritional problems, and malnutrition was common at the end of treatment. Inflammation-driven muscle depletion during treatment is challenging, but recovery after treatment seems possible. Malnutrition was associated with worse HRQoL before and after treatment; however, toxicity during treatment may contribute to impaired HRQoL irrespective of nutritional status. 

Disclosure of Interest: None declared