Malnutrition in Head and neck cancer (HNC) patients can be present at the\nmoment of diagnosis. The nutritional status is determinant for the treatment\nsuccess and quality of life of the patients. The nutritional status gradually declines\nduring treatment and the majority of patients undergoing treatment\nwill need nutritional therapy. On the other hand, HNC, like other cancers,\ncan induce a paraneoplastic syndrome that leads to cachexia. This cachexia\nstatus is most of the times the cause of death or the cause of treatment failure.\nSo, early identification of malnutrition high risk patients is crucial to start an\nadequate nutrition support intervention in HNC patients. This study aims to\nidentify HNC patients who present malnutrition or higher risk of malnutrition;\nto signalize variables that support early identification of high-risk patients\nof becoming malnourished and to establish a dynamic relationship between\nmalnutrition risk in these patients and Quality of Life (QoL) impacts.\nFor six months consecutive outpatients with HNC admitted at the Head &\nNeck Unity of Oncology Portuguese Institute--Porto were asked to participate\nin the research (n = 114). The European Organisation for Research and Treatment\nof Cancer (EORTC) cancer-specific HRQoL questionnaire-QLQ-C30\nand Malnutrition Universal Screening Tool, MUST were used. At the moment\nof first presentation, 32 patients (28.1%) presented high-risk of malnutrition.\nHNC patients with oral cavity and oropharynx tumour locations,\nolder, with low literacy or with BMI under 18.5 at the moment of diagnosis,\nrepresent a high-risk group. When HNC is considered, a dynamic and bi-directional\nconnection between malnutrition and QoL is observed. A significant (p\n< 0.001) difference in the scores of Global health status/QoL according to the\nmalnutrition risk group was found: 62.96, 53.33, 42.71 for low, medium and\nhigh malnutrition risk respectively. Also, Emotional and social functional scales\nand all symptom scales--including pain, presented significant differences\nbetween high and medium risk of malnutrition patients. Fatigue , pain, insomnia\n, appetite loss and financial difficulties were domains directly related\nto high risk of malnutrition patients. Pain scores were significantly higher\n(43.23) in the high-risk patients when compared to medium risk patients\n(11.67). Nutrition support should be considered at any stage of the pathway\n--specially in high risk group--in order to optimize tumour treatment results,\nreduction of adverse effects of therapy and improving both QoL and\nsurvival.
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