ESTRO 2025 - Abstract Book

S1009

Clinical – Head & neck

ESTRO 2025

2011

Digital Poster A prospective study about oral nutrition supplement in local advanced nasopharyngeal carcinoma patients: an update of long-term survival Yuan-yuan Chen 1 , Shuang Huang 2 , Yong-hong Hua 2 , Feng Jiang 2 , Cai-neng Cao 2 , Xiao-Zhong Chen 2 1 Department of Radiation Oncology, Sun Yat-sen University Cancer Centre, Guangzhou, China. 2 Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, China Purpose/Objective: Radiotherapy and chemotherapy will aggravate malnutrition of malignant tumor patients and influence the prognosis. However, there is no reliable evidence that nutritional intervention can improve the survival of nasopharyngeal carcinoma (NPC) patients. Our prospective study aims to explore whether preventive oral nutritional supplements (ONS) can improve the long-term survival of locally advanced NPC. Material/Methods: Eligible patients were prospectively enrolled and received three cycles of induction chemotherapy (docetaxel and cisplatin) combined with concurrent chemoradiotherapy (Clinical trial registration number: NCT 02948699). Participants were randomly assigned into two groups at a 1:1 ratio. The intervention group received preventive ONS alongside their standard diet from the initiation of radiotherapy to reach an energy intake target of 30 kcal/kg/day. In contrast, the control group maintained a regular diet and only received additional nutritional support when they experienced severe malnutrition. We collected data on clinical characteristics prior to treatment, after radiotherapy and three months post-radiotherapy; long-term survival outcomes were monitored over time. Results: From October 2016 to May 2018, 114 patients (male vs female = 83 vs 31) were randomly assigned into an intervention (n=58) and a control group (n=56). The last follow-up was conducted in May 2023, the median OS and PFS were 63.6 and 62.1 months. There were no significant differences in 5-year OS(86.2% vs 83.9%), PFS (75.9% vs 77.2%), DMFS(84.5% vs 89.3%) and LRRFS (82.8% vs 85.7%) between two groups. In our study, the intervention compliance rate was 56.9% and the reactive intervention rate was 19.6% in the control group. Intervention compliance rate, sex, smoking history, overweight and total protein were significant prognostic factors. Subgroup analysis suggested that the reactive intervention group had more significant decrease in body weight and BMI before and after radiotherapy, higher nasal feeding rate and the worst prognosis (P=0.037). The response intervention rate of female patients was significantly higher than that of male patients, but the prognosis was also significantly better than male patients (96.7% vs 83.1%, p=0.014). Among the male group, weight loss before treatment and continuous weight loss 3 months after radiotherapy, overweight/obesity before and after treatment, high triglyceride, and receiving reactive intervention were significant adverse prognostic factors. Conclusion: Current prophylactic ONS interventions do not significantly improve the long-term survival of local advanced NPC patients, which may be related to poor intervention compliance. Precise nutrition interventions based on different gender, different baseline nutritional status and health status may be needed in the future.

Keywords: Nasopharyngeal carcinoma, nutrition intervention