Impact of weight loss in patients with head and neck carcinoma undergoing radiotherapy: is it an underestimated phenomenon? A radiation oncologist's perspective

Nutrition is a crucial topic in oncology, a worsening in nutritional status being able to influence both the course of the disease and its outcome. Malnutrition is a pathological state characterized by an inadequate intake of energy and/or nutrients to meet the biological needs of the body, leading to a systemic catabolic state with potentially reversible changes in body composition and function.(1) Weight loss, one of the most characteristic signs of malnutrition, is a common finding in patients with head and neck (HN) cancer and is associated with poor prognosis. 2,3 During radiotherapy (RT) and chemoradiotherapy, the percentage of malnourished patients rises to 44-88%.(3) Moreover, critical weight loss (>5% from the start of RT until week 8 or >7.5% until week 12)(4) in HN patients may be seen in as high as 57% of patients.(1) Therefore, there is a need to assess the role of nutritional support in the comprehensive management of these patients. Here we briefly outline the current lack of consensus on this issue and why more high-quality studies are required.