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CLINICAL AND NUTRITIONAL PREDICTORS OF RISK DURING RADIOTHERAPY IN HEAD AND NECK CANCER – A PROSPECTIVE OBSERVATIONAL STUDY

SIMONA MARINESCU 1,2#, MIRUNA-MARIA APETROAEI 1*, MANUELA GHICA 1, ANDREEA LETIȚIA ARSENE 1,3, ROXANA DARABONȚ 1#, DENISA IOANA UDEANU 1,3

1 “Carol Davila” University of Medicine and Pharmacy, 6 Traian Vuia Street, 020956, Bucharest, Romania
2 Amethyst Radiotherapy Centre, 42 Drumul Odăi, 075100, Otopeni, Romania
3 “Marius Nasta” Institute of Pneumophthisiology, 90 Viilor Street, 050159, Bucharest, Romania

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This prospective observational study was conducted at Amethyst Radiotherapy Clinic, Bucharest (August 2023 - April 2024) to evaluate nutritional risk in patients with head and neck cancers undergoing radiotherapy. A total of 135 patients were assessed using anthropometric parameters, the Nutritional Risk Screening (NRS-2002) and a nutritional evaluation. At baseline, 26.7% were overweight, 17.8% obese and 5.2% underweight. Despite this heterogeneity, 45.9% of patients presented with moderate to severe nutritional risk (NRS ≥ 2). Weight loss of ≥ 5% occurred in 36.3% of patients before radiotherapy. It rose to 45.2% during treatment, with a higher prevalence in oropharyngeal and oral cavity tumours, as well as in patients receiving concomitant chemoradiotherapy (p = 0.029). Oral candidiasis and taste alterations further compromised intake, although only taste disorders correlated with the treatment type (p = 0.029). These findings underscore that nutritional deterioration is frequent, independent of baseline BMI and is aggravated by multimodality therapy. Early screening and individualised nutritional support are needed, with significant implications for supportive pharmacotherapy and treatment tolerance.