Dynamic changes in nutritional parameters, inflammatory, and immune biomarkers during (chemo-) radiotherapy for head...

To comprehensively investigate the dynamic changes and correlations among nutritional parameters, inflammatory, and immune biomarkers for head and neck cancer (HNC) patients during (chemo-)radiotherapy.

Body composition measurements, subjective nutritional assessments, and hematological biomarkers were prospectively evaluated at four time points: pre-radiotherapy (T1), mid-radiotherapy (T2), at the completion of radiotherapy (T3), and 1 month afterward (T4).

A total of 65 patients completed four follow-ups. Longitudinal analysis revealed statistically significant differences (all P < 0.05) in nutritional, inflammatory, and immune parameters across the four time points (T1-T4). Nutritional parameters including body weight, body mass index, fat-free mass, soft lean mass, skeletal muscle mass, body fat mass, handgrip strength, Nutritional Risk Screening 2002 (NRS2002) score, Patient-Generated Subjective Global Assessment (PG-SGA) score, Karnofsky Performance Status (KPS) score, daily energy intake, daily protein intake, albumin, total protein, prealbumin, hemoglobin, platelet, and red blood cell count all demonstrated significant temporal changes. Similarly, inflammatory/immune biomarkers including white blood cell count, neutrophil count, lymphocyte count, T-lymphocyte count, B-lymphocyte count, C-reactive protein, procalcitonin, interleukin-6, interleukin-10, interferon-γ, and tumor necrosis factor-α showed significant fluctuations during radiotherapy. Spearman's correlation analysis demonstrated associations among nutritional parameters, inflammatory, and immune biomarkers at T3 (all P < 0.05).

Our prospective study demonstrates that patients with HNC experience progressive deterioration in nutritional status (particularly fat-free mass loss) during (chemo-)radiotherapy, which is accompanied by heightened inflammatory responses and diminished immune function. These findings strongly support the integration of multimodal nutritional-inflammatory-immune monitoring protocols into routine oncologic care throughout radiotherapy.