Nutritional Statusin Locally Advanced or Metastatic Solid Cancer Patients Treated With Chemotherapy, Radiotherapy, and Immunotherapy in Spanish Outpatient Oncology Units

Abstract

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.Objectives Malnutrition is a prevalent condition in cancer patients that significantly impacts patients' clinical outcomes and health-related quality of life (HR-QoL). The outcome was to characterize the nutritional status by describing the prevalence of malnutrition (mild, moderate, or severe) and its risk in outpatient cancer patients. Methods Multicenter, prospective, cross-sectional, descriptive, two-cohort study conducted on consecutive adult patients with locally advanced or metastatic solid tumors (stages III-IV). The study was conducted in 10 Spanish hospitals distributed all over the Spanish geography, with a recruitment period of 5 months (between April and September 2020). Study patients were divided into two groups according to their cancer therapy: group A, patients who underwent immunotherapy, and group B, patients who received combined therapy (immunotherapy plus chemotherapy and radiotherapy). Results A total of 585 patients were included. The proportion of patients at risk of malnutrition was notably more significant in the combination group (chemotherapy and/or radiotherapy) than in the immunotherapy-only group (28.3% versus 58.5%, respectively, P < .0001). According to this evaluation the highest proportion of patients at risk were those with pancreatic cancer (51 patients; 89.5%), followed by large intestine cancer (52 patients; 55.3%) and lung cancer (56 patients; 29.3%), P < .0001. Conclusions Patients treated with only immunotherapy seemed to have better nutritional status, which indicated health-related quality of life improvement. Additionally, there was a trend associating nutritional status with tumor location. Treatment strategy, treatment duration, performance status, and treatment location were independently associated with malnutrition.