Association of a structured nutrition-centred multidisciplinary supportive-care program with treatment tolerance and clinical outcomes in patients undergoing precision radiotherapy for head and neck cancer: a prospective cohort study
Abstract
Malnutrition, systemic inflammation, and treatment-related toxicity may compromise radiotherapy tolerance in patients with head and neck squamous cell carcinoma (HNSCC). We evaluated a structured nutrition-centred multidisciplinary supportive-care program during precision radiotherapy. This prospective cohort included 258 patients with HNSCC receiving intensity-modulated or volumetric-modulated arc radiotherapy. Patients entered the comprehensive nutritional management (CNM) group ( n = 129) or usual care (UC) group ( n = 129) according to program availability. Outcomes included radiotherapy interruption, Grade ≥ 3 oral mucositis, treatment delay, longitudinal nutritional and inflammatory markers, quality of life, and exploratory survival outcomes. Linear mixed-effects, parsimonious logistic, and Cox regression models were used. Radiotherapy completion without major interruption was 95.3% in the CNM group and 89.1% in the UC group ( P = 0.063). Grade ≥ 3 oral mucositis was less frequent with CNM (14.0% vs. 26.4%; P = 0.013), as was Grade ≥ 2 dysphagia (17.1% vs. 28.7%; P = 0.026). Treatment delay was shorter with CNM [2 (IQR 1–3) vs. 5 (IQR 3–7) days; P = 0.018]. CNM was associated with more favorable longitudinal trajectories of PNI, SII, global health status, and swallowing symptoms (all interaction P ≤ 0.020). Adjusted analyses showed lower odds of severe mucositis (OR, 0.50; 95% CI, 0.27–0.92), while the association with major interruption was not statistically significant (OR, 0.43; 95% CI, 0.17–1.05). A structured nutrition-centred multidisciplinary supportive-care program was associated with lower treatment-related toxicity, shorter delays, and more favorable nutritional, inflammatory, and quality-of-life trajectories during radiotherapy.
Related
- Implementation of a structured early oral supportive-care pathway and early oral health recovery after oral cancer resection and free-flap reconstruction: a prospective observational cohort study
- Worsening of Oral Health Parameters After Head and Neck Radiotherapy-Findings from a Multidisciplinary Head and Neck Tumor Board: A Prospective Observational Study.
- Longitudinal Improvement in Waist-to-Height Ratio During SGLT-2 Inhibitor Therapy Within a Structured Multidisciplinary Care Model: A Prospective Real-World Cohort Study
- Multidisciplinary attitudes towards LLM-structured oncologic CT reports: a prospective fixed-sequence questionnaire study.
- Reduced serum Dickkopf-1 levels as a potential supportive biomarker for the development and severity of retinopathy of prematurity: a prospective observational clinical study
BibTeX
@article{su2026association,
title = {{Association of a structured nutrition-centred multidisciplinary supportive-care program with treatment tolerance and clinical outcomes in patients undergoing precision radiotherapy for head and neck cancer: a prospective cohort study}},
author = {Na Su and Zhongchao Huo and Zhiwei Zhang and Yunxiao Wang},
journal = {Scientific Reports},
year = {2026},
month = oct,
doi = {10.1038/s41598-026-73876-y},
url = {https://www.nature.com/articles/s41598-026-73876-y},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association of a structured nutrition-centred multidisciplinary supportive-care program with treatment tolerance and clinical outcomes in patients undergoing precision radiotherapy for head and neck cancer: a prospective cohort study
AU - Na Su
AU - Zhongchao Huo
AU - Zhiwei Zhang
AU - Yunxiao Wang
PY - 2026
DA - 2026/10/01
JO - Scientific Reports
DO - 10.1038/s41598-026-73876-y
UR - https://www.nature.com/articles/s41598-026-73876-y
AB - Malnutrition, systemic inflammation, and treatment-related toxicity may compromise radiotherapy tolerance in patients with head and neck squamous cell carcinoma (HNSCC). We evaluated a structured nutrition-centred multidisciplinary supportive-care program during precision radiotherapy. This prospective cohort included 258 patients with HNSCC receiving intensity-modulated or volumetric-modulated arc radiotherapy. Patients entered the comprehensive nutritional management (CNM) group ( n = 129) or usual care (UC) group ( n = 129) according to program availability. Outcomes included radiotherapy interruption, Grade ≥ 3 oral mucositis, treatment delay, longitudinal nutritional and inflammatory markers, quality of life, and exploratory survival outcomes. Linear mixed-effects, parsimonious logistic, and Cox regression models were used. Radiotherapy completion without major interruption was 95.3% in the CNM group and 89.1% in the UC group ( P = 0.063). Grade ≥ 3 oral mucositis was less frequent with CNM (14.0% vs. 26.4%; P = 0.013), as was Grade ≥ 2 dysphagia (17.1% vs. 28.7%; P = 0.026). Treatment delay was shorter with CNM [2 (IQR 1–3) vs. 5 (IQR 3–7) days; P = 0.018]. CNM was associated with more favorable longitudinal trajectories of PNI, SII, global health status, and swallowing symptoms (all interaction P ≤ 0.020). Adjusted analyses showed lower odds of severe mucositis (OR, 0.50; 95% CI, 0.27–0.92), while the association with major interruption was not statistically significant (OR, 0.43; 95% CI, 0.17–1.05). A structured nutrition-centred multidisciplinary supportive-care program was associated with lower treatment-related toxicity, shorter delays, and more favorable nutritional, inflammatory, and quality-of-life trajectories during radiotherapy.
SN - 2045-2322
ER -