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Nutrition impact symptoms and weight loss in head and neck cancer during radiotherapy: a longitudinal study
  1. Sanli Jin1,
  2. Qian Lu1,
  3. Yan Sun2,
  4. Shaowen Xiao2,
  5. Baomin Zheng2,
  6. Dong Pang1 and
  7. Ping Yang1
  1. 1 Department of Medical and Surgical Nursing, Peking University School of Nursing, Beijing, China
  2. 2 Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, China
  1. Correspondence to Dr Qian Lu, Peking University School of Nursing, Beijing 100191, China; luqian{at}; Dr Yan Sun, Peking University Cancer Hospital & Institute, Beijing 100142, China; ysunemail{at}


Objective Patients with head and neck cancer (HNC) receiving radiotherapy (RT) are at high risk of weight loss (WL) due to a variety of nutrition impact symptoms (NIS). This study aimed to describe the NIS through the Head and Neck patient Symptom Checklist and body weight over time and further explore the impact of NIS on WL in patients with HNC undergoing RT.

Methods This was a prospective, longitudinal observational study. NIS and body weight of 117 participants were assessed at baseline, mid-treatment and post-treatment of RT. Generalised estimation equations (GEE) were used to conduct repeated measures analysis of NIS interference score and body weight at each time point and estimate the impact of NIS interference score on WL.

Results All participants experienced a substantial increase in the mean number of NIS during RT, with each patient having eight to nine NIS at mid-treatment and post-treatment. Marked increases were noted in almost each NIS score during RT. Compared with their baseline body weight, 97 (82.9%) and 111 (94.9%) participants experienced WL at mid-treatment and post-treatment, with the mean WL of 2.55±1.70 kg and 5.31±3.18 kg, respectively. NIS of dry mouth (β=−0.681, p=0.002, 95% CI −1.116 to −0.247), difficulty swallowing (β=−0.410, p=0.001, 95% CI −0.651 to −0.169) and taste change (β=−0.447, p=0.000, 95% CI −0.670 to −0.225) impacted WL significantly in GEE multivariate model.

Conclusions Patients with HNC experience a variety of NIS which have significant impact on WL during RT. Assessment of NIS, especially dry mouth, difficulty swallowing and taste change, should be given more considerable attention in the supportive care of patients with HNC.

  • head and neck
  • supportive care
  • symptoms and symptom management

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  • Contributors SJ, QL and YS conceived and designed the study. SJ, SX and BZ participated in the data collection and statistical analysis. SJ, QL, YS, DP and PY contributed to interpretation of findings. SJ led the writing of the manuscript, with input from QL, YS and DP. All authors reviewed the manuscript and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Biomedical Ethics Committee of Peking University (IRB00001052-17002). Written informed consent was obtained from all participants.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data generated by our research that supports our article are available upon reasonable request.