Nutritional Issues in Head and Neck Cancer Patients

Abstract

The purpose of this paper is to update the oncologist on the correct approach to the nutritional care of the head and neck cancer patient. Recent scientific contributions on this issue, with a special emphasis on international guidelines and randomised clinical trials (RCTs), are reviewed. The following points are noteworthy: 1. Despite the advances in early diagnosis and modern treatment of head and neck cancer, this tumour still ranks first regarding frequency and severity of weight loss, both at the clinical presentation and during the therapy. 2. This is due to the combination of poor alimentation because of the tumour mass localization, as well as of the presence of an inflammatory response which furtherly drives catabolism. 3. Several studies have shown a very limited role for a dietary counselling unless it includes oral nutritional supplements which are protein or omega-3 fatty acid enriched. 4. A parental nutritional supplementation could represent an acceptable short-term alternative. 5. Long-term nutritional support relies on the use of percutaneous endoscopic gastrostomy (PEG), whereas the role of a prophylactic or “a la demande” PEG is still unsettled and requires further investigations. In conclusion, the nutritional approach using specific formulas and the appropriate route of administration should be part of the therapeutic armamentarium of the modern oncologist.

Inflammation Status and Body Composition Predict Two-Year Mortality of Patients with Locally Advanced Head and Neck Squamous Cell Carcinoma under Provision of Recommended Energy Intake during Concurrent Chemoradiotherapy

“…Patients with a higher OCC Factor 3 showed less treatment interval TBM loss, including the loss of both LBM and ASM, but they also showed more deaths within 2 years ( Table S2 and Figure 3 ). This observation is different from that of previous studies reporting that pretreatment or treatment interval muscle loss induced by cancer or chemotherapy is associated with poor treatment outcomes in patients with cancer [ 79 , 80 , 81 , 82 , 83 ]. The patients were older, received a greater daily calorie supply, underwent feeding tube treatment for a longer duration, and even failed to develop TFM loss during CCRT, as compared to patients with a low OCC Factor 3 ( Table S2 ).…”

Profile of Cachexia Parameters and Dietary Intakes in Advanced Stage of Nasopharyngeal Cancer Patients: Study inThree Hospitals in Semarang, Central Java, Indonesia

“…In HNC patients, including NPC, inadequate dietary intake is associated with various symptoms, including dysphagia, odynophagia, and anorexia, which can lead to weight loss. During cancer therapy, such as chemotherapy, radiotherapy, or a combination of both, the development of mucositis, xerostomia, dysphagia, dysgeusia, and depression can lead to decreased dietary intake, weight loss, and 20% of patients withdraw from therapy 28 .…”

Nutritional Management of Patients with Head and Neck Cancer—A Comprehensive Review

“…Furthermore, it causes treatment breaks with a higher economic burden and decreased functional performances that cumulatively lead to decreased quality of life and higher mortality rates. Interestingly, overweight and obese people with higher BMIs are at the same risk of all of the mentioned complications [6,13,[25][26][27]. Hence, studies have shown that weight loss before treatment was one of the main independent survival predictors, while nutritional support before surgery can lead to significant beneficial changes in quality of life with fewer postoperative infectious complications [28,29].…”