Relationship between changes in nutritional status during treatment and overall survival of newly diagnosed nasopharyngeal carcinoma patients

Purpose: This study investigates the relationship between changes in nutritional status during treatment and overall survival in NPC patients. Method: Using a prospective cohort design, the electronic health records of newly diagnosed NPC patients from a medical center in Taiwan (from January 1, 2018, to March 31, 2024) were analyzed. A total of 73 newly diagnosed NPC patients were tracked; nutritional indicators such as body mass index (BMI), prealbumin levels, and Patient-Generated Subjective Global Assessment (PG-SGA) scores were recorded at four time points: one week before treatment, the first week of treatment, and four and eight weeks after treatment began. Results: The study found that most patients experienced a decrease in BMI (B = −0.62, p < .001) and prealbumin levels (B = −0.79, p = .015) during treatment, although BMI remained in the overweight range and prealbumin stayed within normal levels. PG-SGA scores increased (B = 1.01, p < .001), indicating a shift from low to moderate nutritional risk. Univariate Cox regression analysis showed that the Charlson Comorbidity Index (HR = 1.86, 95% CI: 1.38–2.51), NPC stage (HR = 15.67, 95% CI: 2.07–118.61), treatment method (HR = 2.96, 95% CI: 1.45–6.04), prealbumin (HR = 2.95, 95% CI: 1.46–5.99), and PG-SGA score trajectories (HR = 2.85, 95% CI: 1.27–6.40) were associated with overall survival. However, multivariate analysis revealed that the survival of NPC patients was only associated with CCI and NPC stage. Conclusions: The study underscores the importance of monitoring nutritional status changes during treatment, particularly prealbumin and PG-SGA trajectories.