Early Nutrition Support Therapy in Patients With Head-Neck Cancer

Expósito, María Rosa Alhambra; Herrera‐Martínez, Aura D.; García, Gregorio Manzano; Calvo, M. Espinosa; Serrano, C. Bueno; Moreno, María

doi:10.20960/nh.1560

Cited by 16 publications

(17 citation statements)

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“…However, the nutritional status of patients is difficult to improve significantly. Some prospective studies have demonstrated the significant effects of early nutritional intervention on RIOM and nutritional status in HNC patients undergoing RT (85,86). Early nutritional interventions can lead to higher serum albumin and hemoglobin levels in HNC patients (87).…”

Section: Early Nutritional Interventionmentioning

confidence: 99%

The Effects of Early Nutritional Intervention on Oral Mucositis and Nutritional Status of Patients With Head and Neck Cancer Treated With Radiotherapy

Zheng

Zhao

et al. 2021

Front. Oncol.

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Radiation-induced oral mucositis (RIOM) is a common side effect after radiotherapy (RT) in head and neck cancer (HNC) patients. RIOM patients with severe pain have difficulty in eating, which increases the incidence of malnutrition and affects patients’ quality of life and the process of RT. The mechanism of RIOM is not fully understood, and inflammatory response and oxidative stress appear to be important for RIOM occurrence and development. The nutritional status of patients is very important for their RT tolerance and recovery. Malnutrition, which can lead to anemia, low protein, decreased immunity and other problems, is an important clinical factor affecting tumor progression and treatment. Recent studies have shown that early nutritional intervention can ameliorate oral mucositis and nutritional status of patients with HNC. However, in clinical practice, early nutritional intervention for patients with HNC is not a conventional intervention strategy. Therefore, this review summarized the possible pathogenesis of RIOM, commonly used assessment tools for malnutrition in patients, and recent studies on the effects of early nutritional interventions on RIOM and nutritional status of patients with HNC. We hope to provide the basis and reference for the clinical application of early nutritional intervention models.

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Section: Early Nutritional Interventionmentioning

confidence: 99%

The Effects of Early Nutritional Intervention on Oral Mucositis and Nutritional Status of Patients With Head and Neck Cancer Treated With Radiotherapy

Zheng

Zhao

et al. 2021

Front. Oncol.

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“…Head and neck cancer (HNC) includes cancer of the oral cavity, pharynx, larynx, hypopharynx, and paranasal sinus [1]. Some risk factors have been described, including smoking, alcohol abuse, and human papillomavirus (HPV) infection [1,2]. HPV plays a role in the development of a subset of HNCs and, notably, oropharyngeal cancer (OPC) [3].…”

Section: Introductionmentioning

confidence: 99%

“…The patients with HNC are particularly at risk of malnutrition due to the basic disease and complications of the oncological treatment such as radiotherapy (RT) or concurrent chemoradiotherapy (CRT). According to the literature, malnutrition is noted in 30-50% of HNC patients, especially located in the oropharynx and the hypopharynx [1]. It is caused by insufficient food intake due to dysphagia, odynophagia, and a lack of appetite caused by the tumor.…”

Section: Introductionmentioning

confidence: 99%

“…It is caused by insufficient food intake due to dysphagia, odynophagia, and a lack of appetite caused by the tumor. It is also secondary to RT/CRT as a consequence of mucositis with the dry mouth, loss of taste, dysphagia, xerostomia, nausea, vomiting [1,10]. According to some authors, in up to 80% of HNC patients undergoing RT, significant weight loss during the treatment period is observed [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

“…It has been shown that during RT or CRT, in 55% of patients, an additional weight loss (10% or more) had been observed [16][17][18]. It is also known that deterioration of NS is associated with increased CRT toxicity, increased risk of infections, which leads to prolonged treatment duration (due to treatment interruptions), poor clinical outcome, increased morbidity and mortality, and decreased quality of life (QoL) [1,11,16,19,20].…”

Section: Introductionmentioning

confidence: 99%

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Nutritional Support in Head and Neck Radiotherapy Patients Considering HPV Status

et al. 2020

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Malnutrition is a common problem in patients with head and neck cancer (HNC), including oropharyngeal cancer (OPC). It is caused by insufficient food intake due to dysphagia, odynophagia, and a lack of appetite caused by the tumor. It is also secondary to the oncological treatment of the basic disease, such as radiotherapy (RT) and chemoradiotherapy (CRT), as a consequence of mucositis with the dry mouth, loss of taste, and dysphagia. The severe dysphagia leads to a definitive total impossibility of eating through the mouth in 20–30% of patients. These patients usually require enteral nutritional support. Feeding tubes are a commonly used nutritional intervention during radiotherapy, most frequently percutaneous gastrostomy tube. Recently, a novel HPV-related type of OPC has been described. Patients with HPV-associated OPC are different from the HPV− ones. Typical HPV− OPC is associated with smoking and alcohol abuse. Patients with HPV+ OPC are younger and healthy (without comorbidities) at diagnosis compared to HPV− ones. Patients with OPC are at high nutritional risk, and therefore, they require nutritional support in order to improve the treatment results and quality of life. Some authors noted the high incidence of critical weight loss (CWL) in patients with HPV-related OPC. Other authors have observed the increased acute toxicities during oncological treatment in HPV+ OPC patients compared to HPV− ones. The aim of this paper is to review and discuss the indications for nutritional support and the kinds of nutrition, including immunonutrition (IN), in HNC, particularly OPC patients, undergoing RT/CRT, considering HPV status.

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The effect of early oral nutritional supplements on improving nutritional outcomes and radiation‐induced oral mucositis for nasopharyngeal carcinoma patients undergoing concurrent chemoradiotherapy

Su,

Lin,

et al. 2023

Head & Neck

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BackgroundTo explore the value of early oral nutritional supplements (ONS) in patients with nasopharyngeal carcinoma (NPC) treated with concurrent chemoradiotherapy (CCRT).MethodsPatients with newly diagnosed II‐IVA stage NPC were analyzed and divided into Early and Routine ONS groups according to whether they received early ONS at the beginning of CCRT. Changes in nutritional indicators, incidence of treatment‐related toxicity, radiation interruption, and completion of CCRT were compared.ResultsIn total, 161 patients with NPC were analyzed, including 72 in the Early ONS group and 89 in the Routine ONS group. Multivariate analysis showed that early ONS was an independent protective factor for concurrent chemotherapy ≥2 cycles, and a protective factor against ≥grade 3 radiation‐induced oral mucositis (RIOM) and weight loss >5%. In stage III‐IVA patients, early ONS was beneficial in decreasing the risk of severe malnutrition.ConclusionsEarly ONS can improve nutritional outcomes, reduce RIOM, and enhance treatment adherence.

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Early Nutrition Support Therapy in Patients With Head-Neck Cancer

Abstract: patients who receive ENS keep their nutritional condition instead of associated effects due to RT. ENS represents an efficient treatment and could prevent malnutrition associated comorbidities in oncologic patients.

Cited by 16 publications

References 0 publications

The Effects of Early Nutritional Intervention on Oral Mucositis and Nutritional Status of Patients With Head and Neck Cancer Treated With Radiotherapy

The Effects of Early Nutritional Intervention on Oral Mucositis and Nutritional Status of Patients With Head and Neck Cancer Treated With Radiotherapy

Nutritional Support in Head and Neck Radiotherapy Patients Considering HPV Status

The effect of early oral nutritional supplements on improving nutritional outcomes and radiation‐induced oral mucositis for nasopharyngeal carcinoma patients undergoing concurrent chemoradiotherapy

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