Objective Cancer patients are at risk of malnutrition, which is associated with poor oncological outcomes. The aim of this study was to assess the incidence of malnutrition before, during, and after radiotherapy in locally advanced cervical cancer patients. In addition, we evaluated the impact of malnutrition on survival, and whether and when malnourished patients were referred to a dietitian. Methods This retrospective cohort study included cervical cancer patients who received primary or adjuvant radiotherapy with curative intent between January 2013 and January 2021. Patient and treatment characteristics, including longitudinal data on weight and dietary care, were retrieved from the electronic patient files. Malnutrition was defined by body mass index and weight loss according to the Global Leadership Initiative on Malnutrition (GLIM). Overall survival was estimated using the Kaplan–Meier method. Cox proportional hazard regression analysis was used to estimate hazard ratios for key prognostic factors. Results A total of 294 patients were included. Median follow-up was 40 months (range 7–101 months). Malnutrition occurred in 44 patients (15%) at baseline, in 132 (45%) during radiotherapy, and in 63 (21%) during follow-up. Referral to a dietician occurred in 45% of the 138 patients who were malnourished before or during radiotherapy. Malnutrition was significantly associated with worse survival after adjusting for age, performance score, diabetes, histology, International Federation of Gynecology and Obstetrics (FIGO) stage, and nodal stage. The 3 year overall survival in patients with malnutrition was 77% (95% confidence interval (CI) 70% to 85%) and without malnutrition 89% (95% CI 83% to 95%); p=0.001). Independent significant risk factors for worse overall survival were: malnutrition, age ˃52 years, adenocarcinoma, FIGO stage III/IV, and N1 disease. Conclusion Malnutrition was common in cervical cancer patients treated with radiotherapy and was associated with a shorter overall survival. Further studies are needed to evaluate the effectiveness of better monitoring of malnutrition and faster and better dietary intervention on survival and quality of life. Data are available upon reasonable request. Research data can be made available on request to the corresponding author, but are not currently freely available online.

中文翻译：

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营养不良与接受宫颈癌放疗的女性生存率低有关

目的 癌症患者面临营养不良的风险，这与肿瘤预后不佳有关。本研究的目的是评估局部晚期宫颈癌患者放疗前、放疗期间和放疗后营养不良的发生率。此外，我们还评估了营养不良对生存的影响，以及营养不良患者是否以及何时被转介给营养师。方法 这项回顾性队列研究包括 2013 年 1 月至 2021 年 1 月期间接受初级或辅助放疗的宫颈癌患者。从电子患者档案中检索患者和治疗特征，包括体重和饮食护理的纵向数据。根据全球营养不良领导倡议 (GLIM)，营养不良是通过体重指数和体重减轻来定义的。使用 Kaplan-Meier 方法估计总生存率。 Cox比例风险回归分析用于估计关键预后因素的风险比。结果共纳入294例患者。中位随访时间为 40 个月（范围 7-101 个月）。基线时有 44 名患者（15%）出现营养不良，放疗期间有 132 名患者（45%）出现营养不良，随访期间有 63 名患者（21%）出现营养不良。在 138 名放疗前或放疗期间出现营养不良的患者中，45% 的患者被转诊至营养师。调整年龄、体能评分、糖尿病、组织学、国际妇产科联合会 (FIGO) 分期和淋巴结分期后，营养不良与较差的生存率显着相关。营养不良患者的 3 年总生存率为 77%（95% 置信区间 (CI) 70% 至 85%），无营养不良患者的 3 年总生存率为 89%（95% CI 83% 至 95%）； p=0.001）。总体生存率较差的独立显着危险因素是：营养不良、年龄≥52岁、腺癌、FIGO III/IV期和N1疾病。结论 营养不良在接受放疗的宫颈癌患者中很常见，并且与较短的总生存期相关。需要进一步的研究来评估更好地监测营养不良以及更快更好的饮食干预对生存和生活质量的有效性。数据可根据合理要求提供。研究数据可以根据通讯作者的要求提供，但目前不能免费在线获取。