Background: The aim of present study was to assess the change in nutritional status of locally advanced head and neck carcinoma patients (LAHNC), who were treated by concomitant chemo-radiation, using Body Mass Index(BMI) and the nutritional status was correlated with local control of disease and the side effects of treatment.

Methods: The present study was conducted in 60 previously untreated, histopathologically proven locally advanced head and neck cancer patients who received conventional radical external beam radiation therapy (66Gy / 33 fractions over 6.3 weeks / 2 Gy per fraction) concomitant with Inj.Cisplatin 75mg/m², 3 weekly.  Nutritional status of patients was performed at time of presentation, at the end of treatment and three months after completion of treatment by using Body Mass Index (BMI).

Result: Thirty five percent patients were mild/moderate underweight and none were severely underweight (BMI 16) before starting treatment. At the end of treatment, 28.33%of patients were mild/moderate underweight (BMI 16.0-18.49) and 33.33% were severely underweight (BMI <16).Approximately forty one percent of patients were mild/moderate underweight and 21.67% of patients were severely underweight at third month of follow up. Grade 3 acute skin radiation reactions were seen in 38.10% mild/moderate underweight patients and 42.87% of obese patients(p value-0.001).Grade 3 acute mucosal radiation reactions were seen in 42.86% mild/moderate underweight patients and 57.14% of patients of obese patients. Complete response was seen in 85.71% mild/moderate underweight patients at end of treatment. No evidence of disease was seen in 80.96% mild/moderate underweight patients at third month of follow up.

Conclusion: The current study concludes that prevalence of underweight patients increases shortly after concomitant chemo-radiation in locally advanced head and neck cancer patients. Subsequently, prevalence of underweight patients substantially decreases during the first three months after treatment.

Keywords: Cancer, head and neck, concomitant chemo-radiation, body mass index, nutrition assessment.

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Ashutosh Kumar

Radiation oncologist, Civil Hospital, Yamunanagar, Haryana, India