Relationship between changes in nutritional status during treatment and overall survival of newly diagnosed nasopharyngeal carcinoma patients

Abstract

Purpose

This study investigates the relationship between changes in nutritional status during treatment and overall survival in NPC patients.

Method

Using a prospective cohort design, the electronic health records of newly diagnosed NPC patients from a medical center in Taiwan (from January 1, 2018, to March 31, 2024) were analyzed. A total of 73 newly diagnosed NPC patients were tracked; nutritional indicators such as body mass index (BMI), prealbumin levels, and Patient-Generated Subjective Global Assessment (PG-SGA) scores were recorded at four time points: one week before treatment, the first week of treatment, and four and eight weeks after treatment began.

Results

The study found that most patients experienced a decrease in BMI (B = −0.62, p < .001) and prealbumin levels (B = −0.79, p = .015) during treatment, although BMI remained in the overweight range and prealbumin stayed within normal levels. PG-SGA scores increased (B = 1.01, p < .001), indicating a shift from low to moderate nutritional risk. Univariate Cox regression analysis showed that the Charlson Comorbidity Index (HR = 1.86, 95% CI: 1.38–2.51), NPC stage (HR = 15.67, 95% CI: 2.07–118.61), treatment method (HR = 2.96, 95% CI: 1.45–6.04), prealbumin (HR = 2.95, 95% CI: 1.46–5.99), and PG-SGA score trajectories (HR = 2.85, 95% CI: 1.27–6.40) were associated with overall survival. However, multivariate analysis revealed that the survival of NPC patients was only associated with CCI and NPC stage.

Conclusions

The study underscores the importance of monitoring nutritional status changes during treatment, particularly prealbumin and PG-SGA trajectories.