A dietitian-led clinic for patients receiving (chemo)radiotherapy for head and neck cancer

Abstract

A dietitian-led head and neck cancer clinic is associated with improved efficiency and nutritional management of head and neck cancer patients and offers a feasible model of care.

Pretreatment weight status and weight loss among head and neck cancer patients receiving definitive concurrent chemoradiation therapy: implications for nutrition integrated treatment pathways

“…Wermker et al developed two prediction models with a prognostic accuracy of 90 % [46]. Kiss et al recently reported on a dietitian-led clinic for head and neck cancer patients undergoing (chemo)radiotherapy [47]. Outcomes included increased first contact for high-risk patients, significantly decreased nutrition-related hospital admissions, improved transition back to oral diets, and reduced unplanned insertions for tube feeding.…”

“…Outcomes included increased first contact for high-risk patients, significantly decreased nutrition-related hospital admissions, improved transition back to oral diets, and reduced unplanned insertions for tube feeding. Overall, patient acceptance was high, quality of care was improved, and a substantial cost savings was realized [47]. …”

The Effect of Prophylactic Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement on Swallowing and Swallow-Related Outcomes in Patients Undergoing Radiotherapy for Head and Neck Cancer: A Systematic Review

“…These results support previous research, which has shown that PEG duration may not be entirely related to dysphagia frequency/severity [50,112]. PEG duration and long-term PEG dependence may also be associated with a number of other factors, including race [95], performance status scores (i.e., Zubrod) [95], age [87], gender [85,87], tumor stage/cancer severity [87,95,118,119], cancer site [85,120], smoking status [118,120], the presence/absence of pre-treatment dysphagia [118,119], and the level of support offered to patients when transitioning from tube to oral feeding [121,122]. Therefore, using PEG dependence/duration as a marker of dysphagia has its drawbacks and may not accurately reflect a patient's swallow physiology or function.…”

Optimising nutrition support in patients with head and neck cancer

“…Two recommend high risk patients receive a proPEG (Brown et al, 2013b;Wood, 2005). The third classifies patients as high or low nutritional risk, but favours a reactive approach to tube placement (Kiss et al, 2012).…”

“…All three sets of guidelines demonstrated significant clinical benefits following implementation such as less weight loss, fewer hospital admissions, reduced length of stay, fewer unplanned nasogastric tube (NGT) insertions, improved transition to oral diet posttreatment and reduced oncologist review at two weeks post-treatment (Brown, Ross, Jones, Hughes, & Banks, 2014a;Hughes et al, 2013;Kiss et al, 2012;Wood, 2005). The…”