Background/Objectives: This analysis aims to evaluate gender-specific differences in nutritional status, body weight changes, and their impact on overall survival (OS) in head and neck cancer (HNC) patients undergoing (chemo)radiotherapy (CRT).Methods: Between 2018 and 2020, 61 HNC (17 female and 44 male) patients were prospectively recruited to receive curative (chemo)radiotherapy. Nutritional assessments included dietary questionnaire screenings and records, anthropometric methods (body mass index, BMI, body composition via bioelectrical impedance analysis (BIA)), and the determination of biomarkers like albumin and CRP. Assessments were conducted before, during, and after (chemo)radiotherapy.Results: Gender differences were observed at baseline in Karnofsky performance status (p= 0.01), daily calorie intake (p= 0.04), phase angle (PA) (p= 0.003), and fat-free mass index (FFMI) (p< 0.001). During CRT, males showed a larger increase in calorie deficit (p< 0.001) and greater reductions in BMI, FFMI, and PA compared to females. Malnutrition risk (MUST score) increased significantly in males (p= 0.008) but not in females. Albumin and total protein declined in both genders, with a more pronounced drop in albumin for females. Survival analysis revealed that, for males, several factors, including baseline calorie deficit, BMI, PA, and FFMI, were linked to survival. For females, only albumin at therapy end was significantly associated with survival (p< 0.001). In multivariable analysis, baseline PA remained a significant predictor of survival for males (p= 0.026).Conclusions: Our findings suggest distinct gender differences in the nutritional and biochemical responses of HNC patients undergoing CRT, indicating the importance of tailored, gender-specific nutritional support during treatment.
背景/目的：本研究旨在评估接受（化学）放射治疗的头颈癌患者在营养状况、体重变化方面的性别特异性差异及其对总生存期的影响。方法：2018年至2020年间，前瞻性纳入61例接受根治性（化学）放射治疗的头颈癌患者（女性17例，男性44例）。营养评估包括饮食问卷筛查与记录、人体测量学方法（体重指数、通过生物电阻抗分析评估的身体成分）以及白蛋白、C反应蛋白等生物标志物检测。评估在（化学）放射治疗前、治疗期间及治疗后进行。结果：基线数据显示，卡氏功能状态评分、每日热量摄入、相位角及去脂体重指数存在性别差异。治疗期间，男性患者热量缺口增幅更大，体重指数、去脂体重指数及相位角下降程度均高于女性。男性营养不良风险评分显著升高，而女性未见明显变化。两组患者白蛋白与总蛋白水平均下降，其中女性白蛋白降幅更为显著。生存分析显示，男性患者的基线热量缺口、体重指数、相位角及去脂体重指数与生存期相关；女性患者中仅治疗结束时白蛋白水平与生存期显著相关。多变量分析表明，基线相位角是男性患者生存期的独立预测因子。结论：头颈癌患者在（化学）放射治疗期间表现出显著的营养与生化反应性别差异，提示治疗期间实施个体化、性别特异性的营养支持具有重要意义。
肿瘤(癌症)患者之家