Patient-generated subjective global assessment and nutritional risk index for assessing nutritional decline during radical chemoradiotherapy in locally advanced head and neck cancer: a prospective single-center Indian study.

Authors

Akhila K, Sweety Gupta, Pooja Doley, Roshni Balu, Harish Kumar, Manoj Gupta, Deepa Joseph

Published in

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. Volume 34. Issue 7. Jun 25, 2026. Epub Jun 25, 2026.

Abstract

Malnutrition is frequent in head and neck cancer patients and may worsen during chemoradiotherapy due to treatment-related toxicities. Early identification of nutritional risk is crucial to enhance treatment tolerance and outcomes. This study aimed to evaluate nutritional status of head and neck cancer patients using Patient-Generated Subjective Global Assessment (PG-SGA) and anthropometric parameters and to assess their association with acute toxicity and treatment response.
This prospective observational study included 78 patients with locally advanced head and neck cancer treated with radical chemoradiotherapy. Baseline nutritional assessment included anthropometric parameters, biochemical markers, PG-SGA, and Nutritional Risk Index (NRI). Nutritional reassessment was done at treatment completion. Acute toxicities were graded using CTCAE v5.0 and treatment response was evaluated at 12 weeks using RECIST 1.1 criteria.
The median age was 57 years and 91% of patients were male. At baseline, 85.9% of patients were well nourished according to PG-SGA, while NRI identified nutritional risk in 51.3% of patients. A significant association was observed between PG-SGA and NRI risk (p = 0.006). Baseline anthropometric parameters did not show significant association with nutritional status. However, serum albumin showed significant association with PG-SGA (p = 0.016) and NRI (p < 0.001). Post-treatment assessment demonstrated nutritional decline in 46.2% of patients. Pre-treatment PG-SGA did not correlate with acute toxicity or treatment response. However, severe dysphagia was significantly associated with post-treatment malnutrition (p < 0.001).
Nutritional deterioration is common during chemoradiotherapy in head and neck cancer patients. Patient-Generated Subjective Global Assessment, together with objective indices such as the Nutritional Risk Index, may help identify patients requiring timely nutritional intervention and swallowing support during treatment.

PMID:
42347847
Bibliographic data and abstract were imported from PubMed on 25 Jun 2026.

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