Early versus conventional nutritional intervention in head and neck cancer patients before radiotherapy: benefits of a fast-track circuit

González-Rodríguez, María; Villar-Taibo, Rocío; Fernández-Pombo, Antía; Pazos-Couselo, Marcos; Sifontes-Dubón, Mildred; Ferreiro-Fariña, S; Cantón-Blanco, Ana; Olmos, Miguel

doi:10.1038/s41430-020-00786-1

Cited by 9 publications

(5 citation statements)

References 31 publications

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“…Nutritional care is an integral component of multi-disciplinary anti-cancer treatments, and has been shown to optimize the clinical outcomes for patients with various cancers (6)(7)(8)(9) . Malnutrition frequently develops in oncology patients due to either the tumor itself or various anti-cancer treatments, and can lead to poorer clinical outcomes (6) .…”

Section: Introductionmentioning

confidence: 99%

Fat mass assessment using the triceps skinfold thickness enhances the prognostic value of the Global Leadership Initiative on Malnutrition criteria in patients with lung cancer

Yin¹,

Fan²,

Lin³

et al. 2021

Br J Nutr

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The present study evaluated whether fat mass assessment using the triceps skinfold (TSF) thickness provides additional prognostic value to the GLIM framework in patients with lung cancer (LC). We performed an observational cohort study including 2672 LC patients at two institutions in China. Comprehensive demographic, disease and nutritional characteristics were collected. Malnutrition was retrospectively defined using the GLIM criteria, and optimal stratification was used to determine the best thresholds for the TSF. The associations of malnutrition and TSF categories with survival were estimated independently and jointly by calculating multivariable-adjusted hazard ratios (HRs). Malnutrition was identified in 808 (30.2%) patients, and the best TSF thresholds were 9.5 mm in men and 12 mm in women. Accordingly, 496 (18.6%) patients were identified as having a low TSF. Patients with concurrent malnutrition and a low TSF had a 54% (HR = 1.54, 95%CI = 1.25 to 1.88) greater death hazard compared with well-nourished individuals, which was also greater compared to malnourished patients with a normal TSF (HR = 1.23, 95%CI = 1.06 to 1.43) or malnourished patients without TSF assessment (HR = 1.31, 95%CI = 1.14 to 1.50). These associations were concentrated among those patients with adequate muscle mass (as indicated by the calf circumference). Additional fat mass assessment using the TSF enhances the prognostic value of the GLIM criteria. Using the population-derived thresholds for the TSF may provide significant prognostic value when used in combination with the GLIM criteria to guide strategies to optimize the long-term outcomes in patients with LC.

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Section: Introductionmentioning

confidence: 99%

Fat mass assessment using the triceps skinfold thickness enhances the prognostic value of the Global Leadership Initiative on Malnutrition criteria in patients with lung cancer

Yin¹,

Fan²,

Lin³

et al. 2021

Br J Nutr

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“…Notably, 30.0%–50.0% of patients with HNSCC are malnourished, and malnutrition is associated with high rates of postoperative complications; therefore, considering the poor response to treatment and high rates of tumor recurrence in this patient population, early nutritional intervention is important. 27 Early nutritional interventions usually include administration of oral supplements or gastrointestinal tube feeding to compensate for inadequate oral intake. 28 Based on Cox proportional hazards regression analysis, we did not observe an association between early nutritional intervention and mortality risk, which is attributable to the small sample size of the study.…”

Section: Discussionmentioning

confidence: 99%

The association between body mass index and efficacy of pembrolizumab as second‐line therapy in patients with recurrent/metastatic head and neck squamous cell carcinoma

et al. 2022

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Background Recent evidence suggested a potential correlation between BMI and the efficacy of immune checkpoint inhibitors in cancer patients. This study aimed to evaluate the prognostic value of the body mass index (BMI) in recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) patients treat with pembrolizumab. Methods The current retrospective cohort study enrolled 49 R/M HNSCC patients underwent at least one cycle of pembrolizumab as second‐line treatment from June 2018 to October 2020. Survival analysis of immunotherapy prognosis and risk factor analysis of age, gender, BMI, ECOG‐PS, CPS, rT‐stage, tumor site, and tube feeding. Results Among the 49 patients, the BMI at the time of immunotherapy ranged from 14.5 to 32.0 kg/m 2 . The Kaplan–Meier analysis showed that the BMI was significantly correlated with overall survival time (OS, p = 0.0007) and progression‐free survival time (PFS, p = 0.0012). BMI, gender, prior treatment, serum albumin level, ECOG‐PS, CPS and rT‐stage were analyzed in multivariate Cox regression model analysis after adjusted for potential confounding clinical variables. Patients with underweight (OS:HR = 6.862, 95% CI:1.566–30.064, p = 0.011; PFS:HR = 5.672, 95% CI:1.364–23.586, p = 0.017);ECOG≥2 (OS:HR = 0.250, 95% CI:0.086–0.731, p = 0.011;PFS:HR = 0.284, 95% CI:0.101–0.805, p = 0.018); CPS <1(OS: HR = 4.34, 95% CI:1.271–15.464, p = 0.019; PFS:HR = 3.859, 95% CI:1.180–12.618, p = 0.025) and rT4‐stage(OS:HR = 4.380, 95% CI:1.452–13.209, p = 0.009;PFS: HR = 3.799, 95% CI:1.240–11.638, p = 0.019) suffered higher risk of mortality. Conclusions The BMI at the time of clinical diagnosis was showed to be an independent predictive factor for R/M HNSCC patients receiving pembrolizumab. Compared with normal weight patients, underweight patients have worse clinical prognosis.

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“…The latest findings also suggest a significant role of controlled physical exercises and rehabilitation in the curation of post-RT malnutrition, sarcopenia, and cachexia. However, a meta-analysis did not confirm the beneficial combina-tion of nutritional support with controlled physical activity regarding patients' nutritional benefits [112]. Moreover, dietetic counseling alone or associated with supplementation by enteral nutrition for three months was not able to prevent a loss of muscle strength and body weight during RT [113].…”

Section: Nutritional Support In Rt-treated Hnc Patientsmentioning

confidence: 96%

“…Clinical symptoms along with body composition evaluation and molecular marker assessment could allow a detailed insight into a patient's condition and should be considered during nutritional screening prior to therapy. It could exclude selected patients from therapy, for whom the therapy complications could be worse than the benefits [111,112]. The assessment of molecular changes seems to be primarily useful because of its ability to objectively reflect the body's condition at the cellular level, including the nutritional status and mechanisms controlling this process.…”

Section: Itgam-323g>a [106]mentioning

confidence: 99%

Nutritional Deficiencies in Radiotherapy-Treated Head and Neck Cancer Patients

Powrózek

Dziwota

Małecka‐Massalska

2021

JCM

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Nutritional deficiencies (malnutrition, cachexia, sarcopenia, and unfavorable changes in the body composition) developing as a side effect of radiotherapy (RT) currently represents a significant but still inaccurately studied clinical problem in cancer patients. The incidence of malnutrition observed in head and neck cancer (HNC) patients in oncological radiology departments can reach 80%. The presence of malnutrition, sarcopenia, and cachexia is associated with an unfavorable prognosis of the disease, higher mortality, and deterioration of the quality of life. Therefore, it is necessary to identify patients with a high risk of both metabolic syndromes. However, the number of studies investigating potential predictive markers for the mentioned purposes is still significantly limited. This literature review summarizes the incidence of nutritional deficiencies in HNC patients prior to therapy and after the commencement of RT, and presents recent perspectives for the prediction of unfavorable nutritional changes developing as a result of applied RT.

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Early versus conventional nutritional intervention in head and neck cancer patients before radiotherapy: benefits of a fast-track circuit

Cited by 9 publications

References 31 publications

Fat mass assessment using the triceps skinfold thickness enhances the prognostic value of the Global Leadership Initiative on Malnutrition criteria in patients with lung cancer

Fat mass assessment using the triceps skinfold thickness enhances the prognostic value of the Global Leadership Initiative on Malnutrition criteria in patients with lung cancer

The association between body mass index and efficacy of pembrolizumab as second‐line therapy in patients with recurrent/metastatic head and neck squamous cell carcinoma

Nutritional Deficiencies in Radiotherapy-Treated Head and Neck Cancer Patients

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