Impact of Nutritional Status on the Quality of Life in Head and Neck Cancer Patients Undergoing Radiotherapy
Malnutrition is prevalent in head and neck cancer patients due to premorbid lifestyles, local effects of the tumor, and side-effects of the treatment. Malnutrition has been reported to have a negative impact on the quality of life of these patients while undergoing treatment. This study aims to...
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Format: | Thesis |
Language: | English English |
Published: |
2009
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Online Access: | http://psasir.upm.edu.my/id/eprint/7171/1/FPSK%28M%29_2009_8a.pdf http://psasir.upm.edu.my/id/eprint/7171/ |
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Summary: | Malnutrition is prevalent in head and neck cancer patients due to premorbid
lifestyles, local effects of the tumor, and side-effects of the treatment.
Malnutrition has been reported to have a negative impact on the quality of
life of these patients while undergoing treatment. This study aims to
determine the impact of nutritional status on quality of life of head and neck
cancer patients undergoing radiotherapy (primary, adjunctive to surgery or
combined with chemotherapy), as well as to identify the contributing factors
to these parameters.
A cross-sectional study was carried out in a convenience sample of 50 head
and neck cancer patients receiving radiotherapy (primary, adjunctive to
surgery or combined with chemotherapy) who were admitted to the
oncology wards, Hospital Kuala Lumpur. Nutritional status was assessed
objectively by using combination of anthropometry, biochemical and dietary
method, and subjectively (using Patient-Generated Subjective Global Assessment or PG-SGA). Quality of life was evaluated by using the
European Organization for Research and Treatment of Cancer Quality of
Life Core Questionnaire (EORTC QLQ-C30 and its head and neck module
(EORTC QLQ-H&N35).
Of 50 patients, 58% (n=29) were found to be malnourished by using objective
criteria, while 84% (n=42) were found to be malnourished by using subjective
measure (PG-SGA). Poor quality of life was reported in 56% of the patients.
None of the sociodemographic factors studied was associated with
malnutrition. Bivariate analysis showed that two clinical variables (treatment
type and radiation dosage) significantly affected nutritional status.
Chemoradiated patients were found to be more malnourished than those
treated with radiotherapy alone or post-operative radiotherapy (F= 7.832,
p<0.05). Multivariate analysis revealed that neoadjuvant chemoradiation and
post-operative radiotherapy significantly affected nutritional status (F =
12.085, p= 0.000, R2= 0.340). Both contributed 34% of the variance seen in the
nutritional status of the patients.
In terms of QoL, 56% of patients had poor QoL. Bivariate analysis showed
that treatment modality and nutritional status were significantly associated
with QoL. Post-operative radiotherapy was associated with better quality of
life, followed by those treated with radiotherapy alone, neoadjuvant
chemoradiation and concurrent chemoradiation (F= 6.721, p<0.05). As anticipated, malnourished patients had significantly poorer QoL (Mann-
Whitney test = 66.5, p<0.05). However, multivariate analysis revealed that
nutritional status was not a significant contributor of QoL. The only two
significant contributors of QoL were household income and post-operative
radiotherapy, and both explained about 40% of the variance seen in the QoL
of the patients (F= 14.901, p = 0.000, R2 = 0.398).
In short, the results of this study has highlighted that malnutrition was very
prevalent in head and neck cancer patients. The findings also provide an
insight into factors that contribute to both nutritional status and QoL. A
longitudinal study is needed in order to determine the real effect of
treatment over time in both nutritional status and QoL of the patients. |
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