Impact of nutrition on outcome: A prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy

Ravasco, Paula; Grillo, I. Monteiro; Marques‐Vidal, Pedro; Camilo, M.

doi:10.1002/hed.20221

Cited by 479 publications

(513 citation statements)

References 27 publications

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“…Cancer studies that reported improvement in QoL were usually accompanied by significant improvement in LBM, 14,15 or significant improvement in PG-SGA or dietary intake. 31,39 Metaanalysis on cancer studies 40 showed higher intensity aerobic exercise was associated with higher QoL, whereas lower intensity aerobic exercise was associated with lower QoL. On the basis of the literature, our results may be explained by the nonsignificant differences observed for changes in nutritional outcomes, body composition and activity time between the groups.…”

Section: Randomisedmentioning

confidence: 47%

Telephone-delivered nutrition and exercise counselling after auto-SCT: a pilot, randomised controlled trial

Hung

Bauer

Horsely

et al. 2014

Bone Marrow Transplant

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Adverse changes in nutrition-related outcomes including quality of life (QoL) occur after PBSC transplantation. This randomised controlled trial aims to evaluate the impact of nutrition and exercise counselling provided at hospital discharge on nutritional status, body composition and QoL post transplantation. Usual care (UC) (n = 19) received no intervention after discharge; extended care (EC) (n = 18) received fortnightly telephone counselling from a dietitian and exercise physiologist up to 100 days post transplantation. Nutritional status (patient-generated subjective global assessment, and diet history), QoL (EORTC QLQ-C30 version 3) and body composition (air displacement plethysmography) were assessed at pre-admission, discharge and 100 days post transplantation. Intervention groups were compared using two-sample t-tests of changes in the outcomes; results were adjusted using analysis of covariance. EC exhibited clinically important but not statistically significant increases in protein intake (14.7 g; confidence interval (CI) 95% − 6.5, 35.9, P = 0.165), cognitive functioning (7.2; CI 95% − 7.9, 22.2, P = 0.337) and social functioning (16.5; CI 95% − 7.3, 40.3, P = 0.165) compared with UC. Relative to pre-admission, EC experienced less weight loss than UC (−3.3 kg; CI 95% − 6.7, 0.2, P = 0.062). Physical activity was not significantly different between the groups. Ongoing nutrition and exercise counselling may prevent further weight loss and improve dietary intake and certain QoL components in autologous PBSC transplantation patients following hospitalisation.

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Section: Randomisedmentioning

confidence: 47%

Telephone-delivered nutrition and exercise counselling after auto-SCT: a pilot, randomised controlled trial

Hung

Bauer

Horsely

et al. 2014

Bone Marrow Transplant

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“…A copy of the randomization sequence was maintained separately from the study personnel. Randomization envelopes were opened prior to the first patient appointment by an individual in a blinded manner (19).…”

Section: Methodsmentioning

confidence: 99%

Effects of nutritional intervention in head and neck cancer patients undergoing radiotherapy: A prospective randomized clinical trial

Kang

Huang

et al. 2016

Molecular and Clinical Oncology

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Abstract. Head and neck malignant tumors have numerous locations of the disease. After patients receive radiotherapy, their nutritional status is very poor, thus the curative effect is unsatisfactory. The aims of the present study were to investigate and analyze the nutritional status of patients with head and neck cancer undergoing radiotherapy (RT) in order to provide positive nutrition intervention for assisting the radiotherapy effect. A total of 40 patients with head and neck cancer were selected using a method of subjective global assessment (SGA) to assess nutritional status, including calorie intake and energy expenditure. In a randomized, controlled study, 20 patients received intensive dietary counseling and nutritional therapy (G1) and 20 received regular dietary as controls (G0) preradiotherapy and postradiotherapy. The primary endpoint was calorie intake and energy expenditure. The secondary endpoint was SGA rating with nutritional therapy. At the end of RT, energy intake showed a net increase in G1 (1,691±301 kcal) compared with that in G0 (1,066±312 kcal) (P<0.05); energy expenditure increased in G1 (1,673±279 kcal) compared with G0 (1,490±298 kcal) (P<0.05). The prevalence of severe malnutrition following radiotherapy was significantly different between the two study groups (10 patients in G0 and 4 patients in G1; P<0.05). The number of the normal malnutrition patients postRT in G0 decreased from 4 to 2 and conversely, in G1 it increased from 3 to 6 (P<0.05). In conclusion, patients with head and neck cancer were most malnutritioned, which impacted on clinical outcome. Timely nutritional intervention can effectively prevent weight loss and muscle wasting.Additionally, it may improve quality of life by decreasing the frequency of severe malnutrition.

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“…7,[12][13][14] Several studies have shown nutritional interventions in HN cancer patients to have a positive impact on their nutritional status, quality of life, and treatment compliance. [15][16][17] In HN cancer patients, several factors contribute to weight loss before, during, and after treatment. Weight loss is usually attributed to the physiological abnormalities associated with the tumor (because of obstruction and interference with swallowing), the tumor host response (such as chronic inflammation and cytokine production), and the adverse effects of cancer treatments.…”

mentioning

confidence: 99%

Predictors of weight loss during radiotherapy in patients with stage I or II head and neck cancer

Nourissat

Bairati

Samson

et al. 2010

Cancer

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BACKGROUND:The purpose of the study was to identify predictors of weight loss during radiotherapy (RT) in patients with stage I or II head and neck (HN) cancer. METHODS: This study was conducted as part of a phase 3 chemoprevention trial. A total of 540 patients were randomized. The patients were weighed before and after RT. Their baseline characteristics, including lifestyle habits, diet, and quality of life, were assessed as potential predictors. Predictors were identified using multiple linear regressions. The reliability of the model was assessed by bootstrap resampling. A receiver operating characteristics curve was generated to estimate the model's accuracy in predicting critical weight loss (!5%). RESULTS: The mean weight loss was 2.2 kg (standard deviation, 3.4). Five factors were associated with a greater weight loss: all HN cancer sites other than the glottic larynx (P<.001), higher pre-RT body weight (P<.001), stage II disease (P ¼ .002), dysphagia and/or odynophagia before RT (P ¼ .001), and a lower Karnofsky performance score (P ¼ .028). There was no association with pre-RT lifestyle habits, diet, or quality of life. The bootstrapping method confirmed the reliability of this predictive model. The area under the curve was 71.3% (95% confidence interval, 65.8-76.9), which represents an acceptable ability of the model to predict critical weight loss. CONCLUSIONS: These results could be useful to clinicians for screening patients with early stage HN cancer treated by RT who require special nutritional attention. Cancer 2010;116:2275-83.

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Impact of nutrition on outcome: A prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy

Abstract: During RT, nutritional interventions positively influenced outcomes, and counseling was of similar/higher benefit; in the medium term, only counseling exerted a significant impact on patient outcomes.

Cited by 479 publications

References 27 publications

Telephone-delivered nutrition and exercise counselling after auto-SCT: a pilot, randomised controlled trial

Telephone-delivered nutrition and exercise counselling after auto-SCT: a pilot, randomised controlled trial

Effects of nutritional intervention in head and neck cancer patients undergoing radiotherapy: A prospective randomized clinical trial

Predictors of weight loss during radiotherapy in patients with stage I or II head and neck cancer

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