PD874 - SEVERE MUCOSITIS AND HYPOALBUMINEMIA AS A PROGNOSTIC TANDEM IN HEAD AND NECK CANCERS TREATED WITH CHEMORADIOTHERAPY: A RETROSPECTIVE STUDY OF 40 CASES

PD874

SEVERE MUCOSITIS AND HYPOALBUMINEMIA AS A PROGNOSTIC TANDEM IN HEAD AND NECK CANCERS TREATED WITH CHEMORADIOTHERAPY: A RETROSPECTIVE STUDY OF 40 CASES

H. Fadriq¹, I. HASSNAOUI^1,*, B. Nouhaila¹, L. Amine¹, N. Karima¹, H. Elkacemi¹, K. Tayeb¹, H. Khaled¹

¹Radiation therapy, national institute of oncology, Rabat, Morocco

Rationale: Oropharyngeal mucositis is the predominant toxicity of chemoradiotherapy in head and neck cancers. Serum albumin, a sensitive marker of nutritional status, may represent an early prognostic indicator in this setting, yet its systematic monitoring remains underutilized in clinical practice.

Methods: Retrospective descriptive study including 40 patients hospitalized for severe mucotisis from 2023 to 2025. Data collected included BMI, serum albumin, CTCAE mucositis grade, treatment interruptions, nutritional support, complications. Nutritional risk was assessed using MUST and NRS-2002 scores.

Results: Mean patient age was 64.8 years (24–84); 55% were male. Tongue (45%) was the most common primary site. Grade 3–4 mucositis was observed in 79% of patients (n=32). A clear dose-response relationship was identified between mucositis grade and albumin decline: grade 4 mucositis was associated with a mean albumin drop of −9.2 g/L and a mean weight loss of 7.3 kg, compared to −2.9 g/L and 1.5 kg respectively for grade 2 (3-fold and 5-fold differences). MUST screening classified 91% of evaluable patients as high nutritional risk. Total parenteral nutrition was required in 80% of cases. A final serum albumin below 34 g/L was identified as a critical threshold: 80% of patients in this subgroup died, compared to 14% of those with albumin ≥ 34 g/L. Overall, favorable outcomes were achieved in 65% of patients, while 30-day mortality reached 30%.

Conclusion:  A final serum albumin below 34 g/L represents a strong prognostic marker associated with 80% mortality in our series. These findings support the systematic monitoring of serum albumin from the onset of grade ≥ 3 mucositis, and advocate for early proactive nutritional intervention  including reinforced parenteral nutrition and consideration of preventive jejunostomy to be integrated into HNC treatment protocols.

Disclosure of Interest: None declared