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Category: Volume 07 Issue 05 May 2019
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Title: Assessment of Nutritional Status of Locally Advanced Head and Neck Carcinoma Patients Treated With Concomitant Chemo-radiation, by using Scored Patient-Generated Subjective Global Assessment (PG-SGA)

Authors: Ashutosh Kumar, Anbu Chandrasekaran, Tarun Kumar

 DOI: https://dx.doi.org/10.18535/jmscr/v7i5.97

Abstract

Background: The aim of present study was to assessed the nutritional status of locally advanced head and neck carcinoma patients (LAHNC) treated with concomitant chemo-radiation by using Scored Patient-Generated Subjective Global Assessment (PG-SGA) and correlated the nutritional status with local control of disease and side effect of treatment.

Methods: The present study was conducted on 60 previously untreated, histopathologically proven patients of locally advanced head and neck carcinoma who received conventional radical external beam radiation therapy (66Gy / 33 fractions over 6.3 weeks / 2 Gy per fraction) concomitant with Inj. Cisplatin 75mg/m2, 3 weekly. Nutritional status of patients was performed at time of presentation, at the end of treatment and three months after completion of treatment by using Scored Patient-Generated Subjective global assessment

Result: Approximately 55% patients had moderate malnutrition (Stage-B) before start of treatment. Then at end of treatment, 56.67% patients were moderately malnourished (stage-B) and 41.67% were severely malnourished (stage-C). At 3rd month of follow up, 50% were moderate malnourished (Stage-B) and 13.33% were severe malnourished (Stage-C). Grade 3 acute skin radiation toxicity was observed in 25% of well nourished patients (stage A) and 41.94% of stage B patients. Grade 3 acute mucosal radiation toxicity was observed in 39.29% patients of stage A and 31% patients of stage B. No evidence of disease was seen in 96.43% patients of Stage-A and 65.62% patients of Stage- B at third month of follow up. The difference between stage-A and B was statistically significant, p value 0.003.

Conclusion: The current study concludes that prevalence of malnutrition increases shortly after concomitant chemo-radiation in locally advanced head and neck cancer patients. Subsequently, prevalence of malnutrition substantially decreases during the first three months after treatment.

Keywords: cancer, head and neck, concomitant chemo-radiation, scored patient-generated subjective global assessment, nutrition assessment.

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Corresponding Author

Ashutosh Kumar

Department of Radiation Oncology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India