ArticleClinical and translational radiation oncology2027
Evaluation of the nutritional and digestive impact of irradiation in nasopharyngeal cancers: the French multicenter retrospective DRAKAR study.
Article in Clinical and translational radiation oncology, 2027. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveRadiotherapy for nasopharyngeal cancers is associated with frequent digestive and nutritional toxicities, weight loss (WL), and malnutrition, criteria of poor tolerance and poor prognosis. The primary objective of DRAKAR was to evaluate the effect of prophylactic enteral nutrition (EN) on weight change (WC) during, at the end of, and after radiotherapy in patients with nasopharyngeal cancer from a non-endemic French population. MATERIALS AND
methodsDRAKAR is a retrospective, multicenter study conducted in five French centers. Patients received radiotherapy with curative intent, with or without concurrent chemotherapy, for primary nasopharyngeal cancer between 2015 and 2024. The primary endpoint was WC according to nutritional support modality at the end of radiotherapy. Secondary endpoints included rates of moderate and severe malnutrition (5% or 10% WL in one month for moderate and severe malnutrition), grade ≥ 3 toxicities, dosimetry parameters (volumes, particles), use and duration of EN and parenteral nutrition, prolonged radiotherapy due to treatment interruption, hospitalizations, and overall survival.
resultsAmong the 124 patients analyzed (59.7% UCNT, 40.3% squamous cell carcinoma), mean WC was -6.45% at the end of radiotherapy. At one month, 35.5% were malnourished, compared with 8% before treatment. EN was used in 55.6% of patients, including 16.1% prophylactically. Prophylactic EN was associated with stabilization of WC after treatment. Regarding malnutrition, age < 55 years was the only significant clinical factor associated with its occurrence, with no association found with toxicity, dosimetric, or therapeutic characteristics.
conclusionIn patients treated for nasopharyngeal cancer, prophylactic EN was associated with post-treatment WC stabilization but not with hospitalization or improved survival. Given potential confounding by indication, these findings should be interpreted cautiously, and prospective studies are needed to confirm the benefit and optimal indications for prophylactic EN.
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