Refusal of nutritional consultations and oral nutritional supplementation during chemoradiotherapy for head and neck cancer results in greater weight loss, elevated CRP, depleted prealbumin levels, higher overall complications, and more frequent need for enteral nutrition interventions, though 5-year overall survival did not differ significantly between groups.
Patients who refused nutritional counseling with oral nutritional supplementation had significantly higher CRP levels at the end of chemoradiotherapy compared to those who accepted it.
Patients who refused nutritional counseling had significantly lower prealbumin levels at the end of chemoradiotherapy compared to those who accepted nutritional support.
Patients who refused nutritional counseling experienced a significantly higher rate of overall complications during chemoradiotherapy.
Patients who refused nutritional counseling required enteral nutrition more frequently during chemoradiotherapy.
Patients who refused nutritional counseling experienced significantly greater weight loss during chemoradiotherapy.
Five-year overall survival did not differ significantly between patients who accepted and those who refused nutritional counseling and oral nutritional supplementation.
A majority of head and neck cancer patients undergoing chemoradiotherapy in this study refused nutritional consultations and oral nutritional supplementation.
This research suggests that head and neck cancer patients who decline nutritional counseling and oral nutritional supplements during their combined chemotherapy and radiation treatment (chemoradiotherapy) experience significantly worse nutritional and clinical outcomes compared to those who accept this support. Specifically, patients who refused nutritional support lost more than twice as much body weight (-11% vs. -5%), had higher levels of a blood marker indicating inflammation (CRP), had lower levels of a protein indicating nutritional status (prealbumin), and were twice as likely to develop complications during treatment. Additionally, one in five patients who refused oral nutritional support eventually required feeding through a tube (enteral nutrition), while none of those who accepted nutritional support needed this more invasive intervention. Despite these significant differences in treatment side effects and nutritional status, the study found that patients' long-term survival (measured at 5 years) was not significantly different between the two groups. This could be due to the relatively small number of patients studied (52 total), or because other factors influencing survival were similar between the groups. Notably, more than half of patients (57.7%) in this study refused nutritional support, highlighting that patient reluctance to engage with nutritional services is a common and clinically meaningful challenge. This research suggests that accepting nutritional counseling and oral supplements during head and neck cancer treatment can help patients maintain their weight, keep inflammation lower, avoid more invasive feeding methods, and experience fewer treatment complications overall. For patients and healthcare providers, these findings underscore the practical value of nutritional support as part of cancer treatment, even when its impact on long-term survival remains uncertain in this dataset.
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Upload Your LabsKrzywon A, Kotylak A, Mrochem-Kwarciak J, Rutkowski T. (2026). Clinical Implications of Nutritional Consultations and Oral Nutritional Supplementation Refusal in Head and Neck Cancer Patients During Chemoradiotherapy.. Nutrients. https://doi.org/10.3390/nu18172765