1 Department of Otolaryngology Jianhu Clinical Medical College Yangzhou University Yancheng 224700 Jiangsu China
2Department of Otorhinolaryngology Yancheng First Hospital Yancheng No. 1 People's Hospital Affiliated Hospital of Medical School
Nanjing University Affiliated to Nanjing University School of Medicine Yancheng 224000 Jiangsu China
3 Department of
Otolaryngology Jiangsu Provincial People's Hospital Nanjing 210029 Jiangsu China
Abstract：Objective To evaluate the pre-treatment nutritional status of nasopharyngeal carcinoma NPC patients who received
chemoradiotherapy and explore the relationship between malnutrition diagnosed by the Global Leadership Initiative on Malnutrition
GLIM and survival outcome. Method This retrospective study was conducted in a series of 175 NPC patients treated with
chemoradiotherapy at our hospitals from January 2017 to December 2021. Using a two-step method the prevalence of malnutrition in
this population was investigated by GLIM criteria. Kaplan-Meier curves with Log-rank test were used to compare progress-free survival
PFS and overall survival OS of malnourished and non-malnourished patients. The independent prognostic factors for NPC patients
were determined by the univariate and multivariate Cox regression analysis. Result A total of 17. 1% 30 / 175 of patients had
malnutrition risk according to the Nutrition Risk Screening 2002. According to GLIM criteria the prevalence of malnutrition was 25. 7%
45 / 175 in NPC patients of which 8. 6% 15 / 175 had unintentional weight loss 9. 7% 17 / 175 had low body mass index BMI
and 20. 6% 36 / 175 had a decrease in muscle mass. The survival analysis indicated that the 3-year PFS rates of malnourished and
non-malnourished patients were 74. 6% and 95. 3% respectively
χ
2 = 15. 871 P<0. 001 . The 3-year OS rates of malnourished and
non-malnourished patients were 73. 1% and 90. 5% respectively
χ
2 = 7. 384 P= 0. 007 . There were significant survival differences
between the two groups for PFS and OS. Malnutrition diagnosed by GLIM criteria was an independent predictor of PFS HR = 2. 335
95%CI = 1. 072-5. 084 P= 0. 031 and OS HR= 4. 810 95%CI = 1. 763-13. 127 P = 0. 002 for NPC patients. Conclusion GLIM
criteria was an effective tool for nutritional assessment and survival prediction of NPC patients and it might be helpful for early
detection of malnutrition and guidance of clinical intervention.
