Weight Loss in Post-Chemoradiotherapy Head and Neck Cancer Patients

Round 1

Reviewer 1 Report

The manuscript entitled “Weight Loss in Post-chemoradiotherapy Head and Neck Cancer Patients” presents interesting issue but some problems must be corrected.

Ethical issue:

It seems that Authors presented in their manuscript part of their previous results (https://www.mdpi.com/2072-6643/12/5/1225), as study seems to be prepared based on the same group and even some data which are presented are the same. But there are two major problems:

• Authors should explain why did they “sliced” their publications
• Authors should explain differences in presented data (e.g. they present exactly the same mean values, but with different SD – it seems impossible)

Abstract:

Abstract should be prepared according to the instructions for authors (without names of the sections).

Authors should present the specific numeric results accompanied by the results of the statistical analysis.

Conclusions must be based on the results of the statistical analysis.

Introduction:

Authors should prepare this section not only to be interesting for Malaysian readers, but to be interesting for international readers. If Authors prepare their manuscript only for their national readers, they should publish it in some national journal. So, Authors should present here international data from various countries, not only the Malaysian ones.

Authors should present the problem of the quality of life of head and neck cancer patients (e.g. https://pubmed.ncbi.nlm.nih.gov/23503912/) and influencing nutritional therapy (e.g. https://pubmed.ncbi.nlm.nih.gov/34960103/).

Authors should formulate the aim of their study within this section.

Materials and Methods:

Authors should clearly describe applied methodology (while presenting detailed questions which were asked)

Authors should explain similarities and differences with previously presented analysis and previously presented results (as described above)

Authors should refer specific ethical committee agreement

The representativeness of the studied group should be reflected.

It seems that Authors did not verify the normality of distribution and they treated all the variables as normally distributed, but based on the presented mean and SD values, it may be supposed that data for some variables were characterised by the distribution different than normal.

Authors should (1) verify the normality of distribution, (2) for normally distributed data present mean and SD values, but for the other distributions – present median, min and max values, (3) apply adequate statistical tests, that are based on the distribution.

Results:

For normally distributed data Authors should present mean and SD values, but for the other distributions – present median, min and max values.

Authors should apply adequate statistical tests, that are based on the distribution.

Instead of figures, Authors should rather present tables.

Discussion:

Within limitations of the study, Authors should reflect representativeness of the studied group.

Conclusions:

Conclusions must be based on the results of the statistical analysis.

Author Contributions:

Authors must clearly present the contributions – e.g. what do they mean by “validation”, if there was no validation within their study

Authors should be consistent – what do they mean by MKN? NMK?

Author Response

Please see the attachment

Author Response File: Author Response.docx

Reviewer 2 Report

On line 216: "

All of HNC patients were malnourished with 32% were moderately malnourished 216 and 68% were severely malnourished at the end of treatment."

I found this explanation: "

Subjective Global Assessment (PG-SGA). Detailed information about the malnutri- 81 tion status measurement has been reported elsewhere (Neoh et al., 2020) 10."

and this:

"Involuntary 5% weight loss in less than 1 month without 228 stabilization or beginning weight gain has been shown to be a valid marker for malnutri- 229 tion in HNC patients."

 

Rather than make the reader search for the definition of "moderate" and "severe" malnutrition, it would be beneficial to explain it in the text of the article.

Line 308: "Overall, HNC patients in this study were weight loss, declining of energy and protein intake, and NIS scores but all of these parameters were improved in post-treatment as compared during RT."

This sentence does not make sense.  Since it is the first sentence of your conclusion, please make the meaning clear.  I'm guessing it meant to say:

"Overall, HNC patients in this study experienced weight loss, fatigue, decreased protein intake, and declining NIS scores during RT, but all of these parameters improved in post-treatment."

 

Author Response

Please see the attachment

Author Response File: Author Response.docx

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.