Y. Su, J. Lv, and T. Li; Department of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
Purpose/Objective(s):This study aimed to assess the current nutritional status of radiotherapy patients in China and their access to nutritional therapy. Additionally, it sought to explore the influence of nutritional status and nutritional therapy on survival in the population. Materials/
Methods: A prospective Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) with 2841 radiotherapy patients admitted from 2013 through 2021 was included in this study. Assessment of nutritional status is based on nutritional scores (e.g., the Nutrition Risk Screening 2002 and The Patient-Generated Subjective Global Assessment), body composition analysis, and blood tests. The primary outcome was all-cause mortality. The effect of nutritional status and nutrition therapy on survival was studied using Cox regression models. Results: During a median follow-up period of 25.97 months, 1185 deaths were recorded among the 2841 radiotherapy patients. A significant proportion of patients were found to be at nutritional risk (72.65% assessed by NRS2002) and experiencing mild-to-severe malnutrition (78.39% assessed by PG-SGA). And 21.75% of patients received nutritional therapy overall, with a higher percentage (32.25%) among those with severe malnutrition. Notably, enteral and supplemental parenteral nutrition was associated with prolonged survival in patients at nutritional risk, even after adjusting for age, PG-SGA score, stage, and serum albumin (hazard ratio, 0.71 and 0.73; 95% CI, 0.55-0.91 and 0.60-0.89; P, 0.007 and 0.001). Moreover, there has been an increase in the proportion of radiotherapy patients receiving nutritional therapy over the past decade, rising from 33.2% to 48%. Conclusion: This study underscores the high prevalence of nutritional risk and malnutrition among Chinese radiotherapy patients, coupled with inadequate access to nutritional therapy. Importantly, nutritional therapy was found to be associated with improved prognosis in patients facing nutritional risk. While there has been progress in promoting nutritional therapy, further efforts are warranted.
