Prognostic Value Of Nutritional Impairment On Treatment-Related Toxicity And Survival In Patients With Nasopharyngeal Carcinoma Taking Normal Nutrition Before Radiotherapy

Background To investigate nutritional impairment during intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC) taking normal nutrition before IMRT and its effect on treatment-related toxicities (TRTs) and survival. Methods Modified nutrition index (m-NI) of 187 patients with NPC, comprised eight indicators (body mass index, circumference of upper arm muscles, total lymphocyte count, red blood cell count, levels of albumin, pre-albumin, transferrin, and hemoglobin), were evaluated before/after IMRT. Patient characteristics, m-NI, and the follow-up data for survival and TRTs were analyzed. Results The m-NI scores of patients with NPC decreased significantly after IMRT. Severe nutritional impairment (SNI; decrease in m-NI score >= 50%) was an independent prognostic factor for overall survival (OS) and an independent risk factor for grade >= 2 oral mucositis. Classification T4 disease and smoking were SNI risk factors. Conclusions SNI during IMRT is a risk factor for oral mucositis and a prognostic factor for worse OS in patients with NPC.