Effects of a Multidisciplinary Residential Nutritional Rehabilitation Program in Head and Neck Cancer Survivors—Results from the NUTRI-HAB Randomized Controlled Trial

Abstract

Head and neck cancer survivors frequently experience nutritional challenges, and proper rehabilitation should be offered. The trial objective was to test the effect of a multidisciplinary residential nutritional rehabilitation programme addressing physical, psychological, and social aspects of eating problems after treatment. In a randomized controlled trial, 71 head and neck cancer survivors recruited through a nationwide survey were randomized to the program or a wait-list control group. Inclusion was based on self-reported interest in participation. The primary outcome was change in body weight. Secondary outcomes included physical function, quality of life, and symptoms of anxiety and depression. Differences between groups at the 3-month follow-up were tested. No significant differences were seen in body weight change, but there were overall trends towards greater improvements in physical function (hand grip strength: p = 0.042; maximal mouth opening: p = 0.072) and quality of life (“Role functioning”: p = 0.041; “Speech problems”: p = 0.040; “Pain”: p = 0.048) in the intervention group. To conclude, a multidisciplinary residential nutritional rehabilitation program had no effect on body weight in head and neck cancer survivors with self-reported interest in participation, but it may have effect on physical function and quality of life. Further research on relevant outcomes, inclusion criteria, and the program’s effect in different subgroups is needed.

Mapping Health-Related Quality of Life, Anxiety, and Depression in Patients with Head and Neck Cancer Diagnosed with Malnutrition Defined by GLIM

“…Treatment-related nutritional problems are one of the most commonly reported problems by patients with HNC [ 4 ] and earlier studies have shown that these may affect social aspects related to food and eating [ 13 , 26 , 27 ]. Not being able to eat in a “socially desirable way” leads many patients to refrain from eating with others [ 13 , 27 ] and rehabilitation has been shown to significantly improve patient reported “trouble with social eating” [ 28 ]. Hence, adopting a holistic approach, i.e., enabling support to all aspects of food and eating for HNC survivors is important not only to recover the patients’ nutritional status, but also to improve HRQoL.…”

An Overview on the Evidence of Physical Activity Interventions in the Health of Individuals with Head and Neck Cancer: Literature Systematic Review

“…After sorting the title and abstract, 490 articles were excluded because they did not meet the inclusion criteria, they were namely cross-references, were characterized by another type of study, animal studies, to investigate individuals with other diseases, under 18 years old, and without physical activity and/or physical exercise intervention. After completing the reading, 26 articles were excluded, totaling 15 articles 4,[10][11][12]14,[24][25][26][27][28][29][30][31][32][33] included in this systematic review (Figure 1).…”

“…The study participants were all diagnosed with head and neck cancer in the laryngeal regions 4,10,12,29,30 , oropharynx 4,12,28 , tongue 29,31,33 , mouth 10,12,[27][28][29][30] , retromolar trigone 29 , epiglottis 29 , amygdala 29 , pharynx 10,12,27,30 , nasophar ynx 33 , thyroid 25,31 , parotid gland 31 , hypopharynx 31,33 , piriform sinus 31 , paranasal sinuses 27 and salivary glands 27 . Five studies did not specify the region 11,14,24,26,32 .…”

“…The age of the participants of the studies varied according to the inclusion criterion: over 18 years 10,27,28,30,33 , from 18 to 75 years 25 , over 20 years old 32 , from 20 to 80 years 29 , from 32 to 76 years 24 and six studies brought only the average age of the participants 4,11,12,14,26,31 .…”

Promising results from a residential rehabilitation intervention focused on fatigue and the secondary psychological and physical consequences of cardiac arrest: The SCARF feasibility study

“…We chose not to include a control group with randomization due to the exploratory nature of the study and uncertainty about recruitment. A recent RCT in the same setting 75 successfully demonstrated how SCARF could be tested using a RCT waiting list design.…”