The effect of quantitative goal exercise combined with whole process refined nutrition management on the nutritional status and quality of life of head and neck cancer patients undergoing radiotherapy: an open-label, randomized, controlled trial

Abstract Objective To explore the clinical effect of a combined intervention comprising Quantitative Goal Exercise (QGE) and Whole-Process Refined Nutrition Management (WP-RNM) on patients with head and neck cancer undergoing radiotherapy, and to provide a basis for improving the nutritional status of these patients. Methods A total of 111 patients with head and neck cancer receiving radiotherapy at the First Affiliated Hospital of Air Force Medical University from September 2023 to September 2024 were selected and randomly divided into an observation group (n = 54) and a control group (n = 57). The control group received routine care, which included nutritional management, dietary guidance, health education, and conventional physiological and psychological interventions based on body weight calculations to maintain hydroelectrolyte and acid-base balance. The observation group received the combined QGE and WP-RNM intervention in addition to routine care. The QGE component consisted of a 6-week personalized program involving aerobic exercise and resistance training for limbs, prescribed as moderate-to-low intensity home-based walking sessions five times per week for at least 15 minutes each. The WP-RNM involved comprehensive nutritional screening, individualized dietary plans, and ongoing monitoring. Primary and secondary outcome measures included Body Mass Index (BMI), Patient-Generated Subjective Global Assessment (PG-SGA) score, Onodera’s Prognostic Nutritional Index (OPNI), total protein, albumin, hemoglobin, mid-upper arm circumference, triceps skinfold thickness, handgrip strength, calf circumference, and quality of life (QOL-C30). Results Compared to the control group, the observation group demonstrated a significantly smaller reduction in BMI at 2, 4, and 6 weeks of intervention (p < 0.001). The observation group also showed significantly greater improvement in PG-SGA scores at 3 and 5 weeks (both p < 0.001), indicating better nutritional status. Regarding objective nutritional indicators, the observation group maintained higher levels of hemoglobin (at 5 weeks, p = 0.026), total protein (at 5 weeks, p = 0.019), and albumin (at 3 weeks, p = 0.018), and experienced a slower deterioration in the OPNI (at 3 weeks, p < 0.001; at 1 month, p = 0.015). Furthermore, the observation group showed significantly greater improvement in multiple quality of life domains, including physical, role, and emotional functioning, overall health status, and symptoms such as fatigue, nausea, vomiting, and pain (all p < 0.05). Conclusion The integration of Quantitative Goal Exercise with Whole-Process Refined Nutrition Management alongside routine care effectively stabilized body weight, improved nutritional status, maintained objective nutritional parameters, and enhanced the quality of life in patients with head and neck cancer undergoing radiotherapy. This combined intervention represents a promising supportive care strategy worthy of clinical application. Trial registration This·trial was registered at ClincalTrials.gov(ChiCTR2300071214) on May 8, 2023.