Nutrition Status and Health-Related Quality of Life Among Outpatients With Advanced Head and Neck Cancer

Urvashi Mulasi, David M. Vock, Harriët Jager-Wittenaar, Levi Teigen, Adam J. Kuchnia, Gautam Jha, Naomi Fujioka, Venkatesh Rudrapatna, Manish R. Patel, Carrie P. Earthman

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


This pilot study evaluated nutrition status and health-related quality of life (HRQOL) outcomes among outpatients with head and neck cancer (HNC). Data were collected from 19 patients (18 males, 1 female) during 3 time points: once before chemoradiotherapy (CRT) initiation and 1 and 3 months after CRT. Nutrition status was evaluated using the Scored Patient-Generated Subjective Global Assessment (PG-SGA). Malnutrition was defined as PG-SGA stage B (moderate/suspected malnutrition) or stage C (severely malnourished). HRQOL was assessed through the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its HNC-specific module (QLQ-H&N35). We found that well-nourished patients reported having fewer issues with pain, fatigue, appetite loss, chewing, sticky saliva, coughing, and social eating than those categorized as malnourished (P < .05). The association between the global quality-of-life score and PG-SGA score was statistically significant but weak in strength (r = -0.37, P = .012). Although PG-SGA identified 70% as either moderately or severely malnourished before treatment initiation, the mean body mass index was in the overweight category (29 ± 5 kg/m 2 ). Compared with pretreatment, patients reported more severe problems with chewing, swallowing, sticky saliva, dry mouth, speech, social eating, and taste and smell sensations at 1-month follow-up, although issues with dry mouth persisted 3 months post treatment (P = .003). In conclusion, malnourished patients reported having worse HRQOL symptoms compared with well-nourished patients. Routine nutrition and psychosocial assessment through PG-SGA and EORTC tools might help identify patients in need of nutrition and psychosocial care.

Original languageEnglish (US)
Pages (from-to)1129-1137
Number of pages9
JournalNutrition in Clinical Practice
Issue number6
StatePublished - Nov 2020

Bibliographical note

Funding Information:
Financial disclosure: Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114. This research was also supported by the USDA National Institute of Food and Agriculture and the Minnesota Agricultural Experiment Station, Project MIN‐18‐104, Hatch Funding. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2020 American Society for Parenteral and Enteral Nutrition

Copyright 2020 Elsevier B.V., All rights reserved.


  • PG-SGA
  • head and neck cancer
  • malnutrition
  • nutrition station
  • quality of life


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