scholarly journals A comparison of the MNA-SF, MUST, and NRS-2002 nutritional tools in predicting treatment incompletion of concurrent chemoradiotherapy in patients with head and neck cancer

Author(s):  
Shun-Wen Hsueh ◽  
Cheng-Chou Lai ◽  
Chia-Yen Hung ◽  
Yu-Ching Lin ◽  
Chang-Hsien Lu ◽  
...  

Abstract Background Concurrent chemoradiotherapy (CCRT) treatment incompletion is a known negative prognosticator for patients with head and neck cancer (HNC). Malnutrition is a common phenomenon which leads to treatment interruption in patients with HNC. We aimed to compare the performance of three nutritional tools in predicting treatment incompletion in patients with HNC undergoing definitive CCRT. Material and methods Three nutritional assessment tools, Mini Nutritional Assessment-Short Form (MNA-SF), Malnutritional Universal Screening Tool (MUST), and Nutritional Risk Screening 2002 (NRS-2002), were prospectively assessed prior to CCRT for HNC patients. Patients were stratified into either normal nutrition or malnourished groups using different nutrition tools. Treatment incompletion and treatment-related toxicities associated with CCRT were recorded. Results A total of 461 patients were included in the study; malnourished rates ranged from 31.0–51.0%. The CCRT incompletion rates were 4.9–6.3% and 14.5–18.2% for normal nutrition patients and malnourished patients, respectively. The tools had significant correlations with each other (Pearson correlation 0.801–0.837, p < 0.001 for all) and accurately predicted the incompletion of CCRT. MNA-SF had the highest performance in predicting treatment-related toxicity, including emergency room visits, need for hospitalization, any grade III or higher hematological adverse events, and critical body weight loss, compared to the other tools. Conclusions MNA-SF, MUST, and NRS2002 were all shown to be competent tools for malnutrition recognition and prediction of treatment incompletion, as well as treatment-related toxicity, in HNC patients undergoing CCRT. We suggest implementing nutritional assessment prior to treatment to improve the rate of treatment completion and to reduce treatment-related toxicity in HNC patients.

2019 ◽  
Vol 122 (6) ◽  
pp. 689-697 ◽  
Author(s):  
Jolene Thomas ◽  
Billingsley Kaambwa ◽  
Christopher Delaney ◽  
Michelle Miller

AbstractVascular surgery patients are nutritionally vulnerable. Various malnutrition screening and assessment tools are available; however, none has been developed or validated in vascular patients. The present study aimed to: (1) investigate the validity of four commonly administered malnutrition screening tools (Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), Nutrition Risk Screen-2002 (NRS-2002) and the Mini-Nutritional Assessment – Short Form (MNA-SF) and an assessment tool (the Patient-Generated Subjective Global Assessment (PG-SGA)) compared against a comprehensive dietitian’s assessment and (2) evaluate the ability of the instruments to predict outcomes. Vascular inpatients were screened using the four malnutrition screening tools and assessed using the PG-SGA. Each was assessed by a dietitian incorporating nutritional biochemistry, anthropometry and changes in dietary intake. Diagnostic accuracy, consistency and predictive ability were determined. A total of 322 (69·3 % male) patients participated, with 75 % having at least one parameter indicating nutritional deficits. No instrument achieved the a priori levels for sensitivity (14·9–52·5 %). Neither tool predicted EuroQoL 5-dimension 5-level score. All tools except the MNA-SF were associated with length of stay (LOS); however, the direction varied with increased risk of malnutrition on the MUST and NRS-2002 being associated with shorter LOS (P=0·029 and 0·045) and the reverse with the MST and PG-SGA (P=0·005 and <0·001). The NRS-2002 was associated with increased risk of complications (P=0·039). The MST, NRS-2002 and PG-SGA were predictive of discharge to an institution (P=0·004, 0·005 and 0·003). The tools studied were unable to identify the high prevalence of undernutrition; hence, vascular disease-specific screening and/or assessment tools are warranted.


2020 ◽  
Vol 8 (1) ◽  
pp. 14-14
Author(s):  
Shirin Fattahi ◽  
Farshad Seyyednejad ◽  
Sarvin Sanaie ◽  
Tahereh Parhizkar ◽  
Elnaz Faramarzi

Introduction: Considering the important role of early detection of malnutrition in patients with cancer and its negative effects on the outcome, as well as the lack of any published article (to the best of our knowledge) about the dietary quality index in head and neck cancer patients treated with chemoradio therapy, we decided to evaluate the nutritional status and dietary quality index in these patients. Methods: In this study, thirty-seven volunteer patients with head and neck cancer were recruited. Nutritional status of the patients was evaluated by Mini Nutritional Assessment (MNA) questionnaire. Dietary diversity score, dietary variety score, and diet quality index–international were calculated to assess the dietary quality of the patients. Results: Our findings indicated that about half of the patients were well nourished and 48.6%were at the risk of malnutrition. We did not find any significant differences between variousdietary quality indices and nutritional status of the patients. However, a significant reverse correlation was observed between dietary quality indices and nutritional status of the patients. Conclusion: According to our findings, the evaluation of nutritional status and the prediction of the patients at higher risks of chemoradio therapy-induced adverse events, may have a major role in the prevention of treatment gaps.


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