The role of radiotherapy planning images in monitoring malnutrition and predicting prognosis in head and neck cancer patients: a pilot study
Abstract Background Adaptive treatment planning can be made in radiotherapy of head and neck cancer patients for reasons such as changes in tumor volume or weight loss. This study aims to find the role of treatment planning images in monitoring radiotherapy-induced malnutrition and predicting the ma...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-05-01
|
| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13014-025-02645-4 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850284669762797568 |
|---|---|
| author | Beste M. Atasoy Birsen Demirel Feyza Nur Ekşi Özdaş Bennur Devran Zehra Nur Kılıç Dilek Gül |
| author_facet | Beste M. Atasoy Birsen Demirel Feyza Nur Ekşi Özdaş Bennur Devran Zehra Nur Kılıç Dilek Gül |
| author_sort | Beste M. Atasoy |
| collection | DOAJ |
| description | Abstract Background Adaptive treatment planning can be made in radiotherapy of head and neck cancer patients for reasons such as changes in tumor volume or weight loss. This study aims to find the role of treatment planning images in monitoring radiotherapy-induced malnutrition and predicting the malnutrition-induced prognosis in head and neck cancer patients. Methods For this study, we analyzed 30 patients who received radiotherapy in our clinic between September 2018 and September 2021. Those patients, both regular and completed weekly dietitian counseling notes during radiotherapy and available adaptive radiotherapy planning images, were included in the analysis. All patients had weekly nutritional interventions, including nutritional and anthropometric changes in weight, height, body mass index (BMI), and lean body mass (LBM). Skeletal muscle volume, called cervical muscle gauge (CMG), was measured from the simulation images of beginning and adaptive radiotherapy. Inflammatory parameters, including the neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), and the systemic inflammatory index (SII), were also calculated from weekly total blood counts. For the analysis, anthropometric measurements were compared at the beginning and adaptive treatment time. Progression-free (PFS) and overall (OS) survival were calculated according to weight and CMG changes. Results The median weight loss percentage was 4.8% (0 to 24%). The mean percentage of weight changes, LBM, and CMG were 6.33%, 3.47%, and 9.28%, respectively. Results indicated that BMI (p = 006), weight (p < 0.001), LBM (p < 0.001), and CMG (p = 0.057) decreased during radiotherapy. Hemoglobin levels decreased (p = 0.005), and inflammatory markers increased. There were significant correlations between weight and LBM (p < 0.0001) and CMG (p = 0.005) loss. The median follow-up was 26 months. Loss of weight (PFS; 65.5% vs. 35.7%, p = 0.09, OS; 73.7% vs. 32.1%, p = 0.09), LBM (PFS; 75% vs. 41.1%, p = 0.118, OS; 65.6% vs. 52%, p = 0.221) and CMG (PFS; 56.3% vs. 47.1%, p = 0.516, OS;76.9% vs. 32.4%, p = 0.059) negatively affected three-year survival. Conclusions Cervical muscle volume measurement may help predict malnutrition in patients receiving radiotherapy for head and neck cancer. Our study shows adaptive planning images may be used for this approach. In addition, this method may help to predict prognosis due to malnutrition in patients undergoing radiotherapy. |
| format | Article |
| id | doaj-art-e0ca24e815924ee8a9dc30c5d2fcd56a |
| institution | OA Journals |
| issn | 1748-717X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj-art-e0ca24e815924ee8a9dc30c5d2fcd56a2025-08-20T01:47:29ZengBMCRadiation Oncology1748-717X2025-05-0120111010.1186/s13014-025-02645-4The role of radiotherapy planning images in monitoring malnutrition and predicting prognosis in head and neck cancer patients: a pilot studyBeste M. Atasoy0Birsen Demirel1Feyza Nur Ekşi Özdaş2Bennur Devran3Zehra Nur Kılıç4Dilek Gül5Department of Radiation Oncology, Marmara University School of MedicineFaculty of Health Science Department of Nutrition and Dietetics, Ondokuz Mayıs UniversityNutrition and Dietetic Division, MH-Marmara University Pendik Education and Research HospitalDepartment of Radiation Oncology, Marmara University School of MedicineMarmara University School of MedicineRadiation Oncology Clinic, MH-Marmara University Pendik Education and Research HospitalAbstract Background Adaptive treatment planning can be made in radiotherapy of head and neck cancer patients for reasons such as changes in tumor volume or weight loss. This study aims to find the role of treatment planning images in monitoring radiotherapy-induced malnutrition and predicting the malnutrition-induced prognosis in head and neck cancer patients. Methods For this study, we analyzed 30 patients who received radiotherapy in our clinic between September 2018 and September 2021. Those patients, both regular and completed weekly dietitian counseling notes during radiotherapy and available adaptive radiotherapy planning images, were included in the analysis. All patients had weekly nutritional interventions, including nutritional and anthropometric changes in weight, height, body mass index (BMI), and lean body mass (LBM). Skeletal muscle volume, called cervical muscle gauge (CMG), was measured from the simulation images of beginning and adaptive radiotherapy. Inflammatory parameters, including the neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), and the systemic inflammatory index (SII), were also calculated from weekly total blood counts. For the analysis, anthropometric measurements were compared at the beginning and adaptive treatment time. Progression-free (PFS) and overall (OS) survival were calculated according to weight and CMG changes. Results The median weight loss percentage was 4.8% (0 to 24%). The mean percentage of weight changes, LBM, and CMG were 6.33%, 3.47%, and 9.28%, respectively. Results indicated that BMI (p = 006), weight (p < 0.001), LBM (p < 0.001), and CMG (p = 0.057) decreased during radiotherapy. Hemoglobin levels decreased (p = 0.005), and inflammatory markers increased. There were significant correlations between weight and LBM (p < 0.0001) and CMG (p = 0.005) loss. The median follow-up was 26 months. Loss of weight (PFS; 65.5% vs. 35.7%, p = 0.09, OS; 73.7% vs. 32.1%, p = 0.09), LBM (PFS; 75% vs. 41.1%, p = 0.118, OS; 65.6% vs. 52%, p = 0.221) and CMG (PFS; 56.3% vs. 47.1%, p = 0.516, OS;76.9% vs. 32.4%, p = 0.059) negatively affected three-year survival. Conclusions Cervical muscle volume measurement may help predict malnutrition in patients receiving radiotherapy for head and neck cancer. Our study shows adaptive planning images may be used for this approach. In addition, this method may help to predict prognosis due to malnutrition in patients undergoing radiotherapy.https://doi.org/10.1186/s13014-025-02645-4Adaptive radiotherapy imagesCervical muscle gaugeHead and neck cancerMalnutritionRadiotherapy |
| spellingShingle | Beste M. Atasoy Birsen Demirel Feyza Nur Ekşi Özdaş Bennur Devran Zehra Nur Kılıç Dilek Gül The role of radiotherapy planning images in monitoring malnutrition and predicting prognosis in head and neck cancer patients: a pilot study Radiation Oncology Adaptive radiotherapy images Cervical muscle gauge Head and neck cancer Malnutrition Radiotherapy |
| title | The role of radiotherapy planning images in monitoring malnutrition and predicting prognosis in head and neck cancer patients: a pilot study |
| title_full | The role of radiotherapy planning images in monitoring malnutrition and predicting prognosis in head and neck cancer patients: a pilot study |
| title_fullStr | The role of radiotherapy planning images in monitoring malnutrition and predicting prognosis in head and neck cancer patients: a pilot study |
| title_full_unstemmed | The role of radiotherapy planning images in monitoring malnutrition and predicting prognosis in head and neck cancer patients: a pilot study |
| title_short | The role of radiotherapy planning images in monitoring malnutrition and predicting prognosis in head and neck cancer patients: a pilot study |
| title_sort | role of radiotherapy planning images in monitoring malnutrition and predicting prognosis in head and neck cancer patients a pilot study |
| topic | Adaptive radiotherapy images Cervical muscle gauge Head and neck cancer Malnutrition Radiotherapy |
| url | https://doi.org/10.1186/s13014-025-02645-4 |
| work_keys_str_mv | AT bestematasoy theroleofradiotherapyplanningimagesinmonitoringmalnutritionandpredictingprognosisinheadandneckcancerpatientsapilotstudy AT birsendemirel theroleofradiotherapyplanningimagesinmonitoringmalnutritionandpredictingprognosisinheadandneckcancerpatientsapilotstudy AT feyzanureksiozdas theroleofradiotherapyplanningimagesinmonitoringmalnutritionandpredictingprognosisinheadandneckcancerpatientsapilotstudy AT bennurdevran theroleofradiotherapyplanningimagesinmonitoringmalnutritionandpredictingprognosisinheadandneckcancerpatientsapilotstudy AT zehranurkılıc theroleofradiotherapyplanningimagesinmonitoringmalnutritionandpredictingprognosisinheadandneckcancerpatientsapilotstudy AT dilekgul theroleofradiotherapyplanningimagesinmonitoringmalnutritionandpredictingprognosisinheadandneckcancerpatientsapilotstudy AT bestematasoy roleofradiotherapyplanningimagesinmonitoringmalnutritionandpredictingprognosisinheadandneckcancerpatientsapilotstudy AT birsendemirel roleofradiotherapyplanningimagesinmonitoringmalnutritionandpredictingprognosisinheadandneckcancerpatientsapilotstudy AT feyzanureksiozdas roleofradiotherapyplanningimagesinmonitoringmalnutritionandpredictingprognosisinheadandneckcancerpatientsapilotstudy AT bennurdevran roleofradiotherapyplanningimagesinmonitoringmalnutritionandpredictingprognosisinheadandneckcancerpatientsapilotstudy AT zehranurkılıc roleofradiotherapyplanningimagesinmonitoringmalnutritionandpredictingprognosisinheadandneckcancerpatientsapilotstudy AT dilekgul roleofradiotherapyplanningimagesinmonitoringmalnutritionandpredictingprognosisinheadandneckcancerpatientsapilotstudy |