Visual analogue scales: a screening tool for assessing nutritional need in head and neck radiotherapy patients
Background: It has been estimated that more than 80% of head and neck cancer patients have significant weight loss during multimodal treatment, leading to poor wound healing, impaired immune function and a decreased tolerance to therapy. This study assesses the use of visual analogue scales (VAS) as a clinical screening tool to identify the nutritional needs of head and neck cancer patients during radical radiotherapy.Methods: Twenty patients with squamous cell carcinoma (10 larynx, 10 pharynx) were assessed four times during their radiotherapy. They completed a VAS, subjectively assessing their appetite, ability to take solids and liquids and sense of taste on a 5-point scale, with very poor and very good as the anchor points. Three-day food diaries, weight, anthropometry and basal metabolic rate were also recorded.Results: The results indicate that although there were no significant differences between the larynx and pharynx groups at the start of radiotherapy, significant differences were apparent by the end of treatment. The VAS showed a significant correlation with energy intake from normal food. This correlation was stronger for solids and appetite than for liquids and taste.Conclusion: The VAS can quickly identify when radiotherapy patients require nutritional intervention and support.