The impact of malnutrition in the radiotherapy pathway in geriatric patients in the onco-surgical settings on behalf of the Turkish Society for Radiation Oncology Study Group (TROD 12-04)

Aim: This study explores the impact of age, malnutrition severity, and malnutrition risk on cancer treatment outcomes and their incidence based on cancer localization and stage, in geriatric and adult patients in Turkey. The study emphasizes the role of oral nutritional supplements (ONS) in improving nutritional status and treatment response in both age groups. Materials and methods: This prospective observational cohort study involved 163 patients with solid tumors receiving radiotherapy (RT) or RT combined with chemotherapy. Malnutrition risk was assessed using the Nutritional Risk Screening (NRS) tool, and malnutrition severity was determined via body mass index (BMI). The significance of age, malnutrition severity, and risk on treatment outcomes and performance status were evaluated by the physician and the Eastern Cooperative Oncology Group Performance Status. Anthropometric measurements recorded before and after treatment were compared to evaluate ONS benefits across age and cancer groups. Results: Of the patients, 50.9 % were aged ≥70 years. A majority had stage III cancer (57.4 %) and lung cancer (38.7 %). Weight and BMI scores significantly decreased from pre-to post-treatment (P < 0.001). Malnutrition risk was higher in stage III cancer (P = 0.039), and geriatric patients had higher baseline NRS scores than adults (P = 0.049). Pre-treatment weight loss and malnutrition risk negatively affected RT response (P < 0.007). Post-treatment malnutrition risk prevalence increased significantly in head and neck cancer patients (P = 0.016). Conclusions: Nutritional therapy is crucial alongside cancer treatment, as pre-treatment weight loss and NRS≥3 negatively affect RT response. Maintaining a healthy nutritional status correlates with better outcomes, necessitating further research to optimize interventions stabilizing weight and BMI during RT.