{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:12:05Z","timestamp":1791900725780,"version":"4.3.4"},"reference-count":59,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T00:00:00Z","timestamp":1618272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health (Ricerca Corrente)","award":["not provided"],"award-info":[{"award-number":["not provided"]}]},{"name":"taxpayer donations \u201c5x1000 per la Ricerca Sanitaria\u201d","award":["not provided"],"award-info":[{"award-number":["not provided"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: The Prognostic Nutritional Index (PNI) is a parameter of nutritional and inflammation status related to toxicity in cancer treatment. Since data for head and neck cancer are scanty, this study aims to investigate the association between PNI and acute and late toxicity for this malignancy. Methods: A retrospective cohort of 179 head and neck cancer patients treated with definitive radiotherapy with induction\/concurrent chemotherapy was followed-up (median follow-up: 38 months) for toxicity and vital status between 2010 and 2017. PNI was calculated according to Onodera formula and low\/high PNI levels were defined according to median value. Odds ratio (OR) for acute toxicity were calculated through logistic regression model; hazard ratios (HR) for late toxicity and survival were calculated through the Cox proportional hazards model. Results: median PNI was 50.0 (interquartile range: 45.5\u201353.5). Low PNI was associated with higher risk of weight loss &gt; 10% during treatment (OR = 4.84, 95% CI: 1.73\u201313.53 for PNI &lt; 50 versus PNI \u2265 50), which was in turn significantly associated with worse overall survival, and higher risk of late mucositis (HR = 1.84; 95% CI:1.09\u20133.12). PNI predicts acute weight loss &gt;10% and late mucositis. Conclusions: PNI could help clinicians to identify patients undergoing radiotherapy who are at high risk of acute and late toxicity.<\/jats:p>","DOI":"10.3390\/nu13041277","type":"journal-article","created":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T10:58:07Z","timestamp":1618311487000},"page":"1277","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Prognostic Nutritional Index Predicts Toxicity in Head and Neck Cancer Patients Treated with Definitive Radiotherapy in Association with Chemotherapy"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9677-3176","authenticated-orcid":false,"given":"Giuseppe","family":"Fanetti","sequence":"first","affiliation":[{"name":"Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9381-1520","authenticated-orcid":false,"given":"Jerry","family":"Polesel","sequence":"additional","affiliation":[{"name":"Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Fratta","sequence":"additional","affiliation":[{"name":"Division of Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Muraro","sequence":"additional","affiliation":[{"name":"Division of Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Lupato","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, \u201cSanta Maria degli Angeli\u201d General Hospital, 33170 Pordenone (PN), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8485-2275","authenticated-orcid":false,"given":"Salvatore","family":"Alfieri","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Immune-Related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Gobitti","sequence":"additional","affiliation":[{"name":"Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Minatel","sequence":"additional","affiliation":[{"name":"Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Matrone","sequence":"additional","affiliation":[{"name":"Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9968-7679","authenticated-orcid":false,"given":"Angela","family":"Caroli","sequence":"additional","affiliation":[{"name":"Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Revelant","sequence":"additional","affiliation":[{"name":"Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Lionello","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Vittorio Veneto General Hospital, ULSS2 Marca Trevigiana, 31029 Vittorio Veneto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviana","family":"Zammattio Polentin","sequence":"additional","affiliation":[{"name":"Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0748-578X","authenticated-orcid":false,"given":"Andrea","family":"Ferretti","sequence":"additional","affiliation":[{"name":"Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Guerrieri","sequence":"additional","affiliation":[{"name":"Division of Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1802-0627","authenticated-orcid":false,"given":"Paola","family":"Chiovati","sequence":"additional","affiliation":[{"name":"Division of Medical Physics, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Bertolin","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Vittorio Veneto General Hospital, ULSS2 Marca Trevigiana, 31029 Vittorio Veneto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Giacomarra","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, \u201cSanta Maria degli Angeli\u201d General Hospital, 33170 Pordenone (PN), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino De","family":"Paoli","sequence":"additional","affiliation":[{"name":"Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3386-5142","authenticated-orcid":false,"given":"Emanuela","family":"Vaccher","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Immune-Related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.radonc.2009.04.014","article-title":"Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 93 randomised trials and 17,346 patients","volume":"92","author":"Pignon","year":"2009","journal-title":"Radiother. 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