Prospective study of resting energy expenditure changes in head and neck cancer patients treated with chemoradiotherapy measured by indirect calorimetry

García-Peris, Pilar; Lozano, Miguel A.; Velasco, Cristina; Cuerda, C.; Iriondo, Teresa; Bretón, Irene; Camblor, M.; Navarro, Carlos

doi:10.1016/j.nut.2005.03.006

Cited by 45 publications

(29 citation statements)

References 26 publications

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“…Concurrent chemotherapy and radiation is associated with significant in-field and systemic toxicities including mucositis, dysphagia, odynophagia, nausea, vomiting, anorexia, fatigue and dysgeusia resulting in difficulty eating [8][9][10]. Furthermore, many patients present with symptomatic tumors that lead to difficulty eating prior to the initiation of treatment, with most patients experiencing a loss of more than 5 % of pretreatment body weight in the 6 months around CTRT [11][12][13][14]. In part, this has been exacerbated by a change in resting energy expenditure, which furthers the loss of lean body mass seen during and immediately after treatment [11,15].…”

Section: Main Textmentioning

confidence: 99%

“…Furthermore, many patients present with symptomatic tumors that lead to difficulty eating prior to the initiation of treatment, with most patients experiencing a loss of more than 5 % of pretreatment body weight in the 6 months around CTRT [11][12][13][14]. In part, this has been exacerbated by a change in resting energy expenditure, which furthers the loss of lean body mass seen during and immediately after treatment [11,15]. Predictors of excessive weight loss during treatment include higher weight at baseline, dysphagia at diagnosis, and higher stage tumors [16].…”

Section: Main Textmentioning

confidence: 99%

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A review of weight loss and sarcopenia in patients with head and neck cancer treated with chemoradiation

2016

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Background: Concurrent chemotherapy and radiation (CTRT) improves disease-free survival in locally advanced head and neck cancer but is associated with numerous acute and chronic toxicities resulting in substantial alterations in body mass and composition. We aim to summarize the current evidence on body composition changes experienced by patients undergoing CTRT, examine the impact of these changes on clinical outcomes and address potential interventions aimed at mitigating the loss. Main Body: Loss of 20 % of pre-CTRT weight predicts poorer treatment tolerance and 30-day mortality. While clinical practice focuses on body weight, emerging data indicates that CTRT causes profound adverse changes in lean body mass (sarcopenia). Higher prevalence of sarcopenia predicts poorer disease-free survival as well as overall survival, lower quality of life and functional performance. The magnitude of CTRT-induced sarcopenia is the equivalent to that observed in a decade of aging in a healthy adult. Alterations in body composition are only explained, in part, by decreased caloric intake; other significant predictors include body mass index, stage, and dysphagia. Lifestyle interventions aimed at preventing loss of whole-body and especially lean mass include nutritional counseling, nutritional supplements, dietary supplements and exercise training. Personalized nutritional counseling has been associated with improvement in quality of life, while the benefits of feeding tube placement are inconsistent. There are inconsistently reported benefits of resistance training in this population. Conclusion: Patients with head and neck cancer undergoing CTRT therapy experience dramatic shifts in body composition, including sarcopenia, which can negatively impact clinical outcomes. Efforts to understand the magnitude, clinical importance and mechanisms of sarcopenia are needed to inform a more personalized approach to mitigating the body composition changes associated with CTRT.

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Section: Main Textmentioning

confidence: 99%

Section: Main Textmentioning

confidence: 99%

A review of weight loss and sarcopenia in patients with head and neck cancer treated with chemoradiation

2016

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“…Other studies have made comparisons only to equationpredicted REE. 17,18 We also compared measured REE to predicted REE and found high percentages of patients with values above 110%, but this was also the case in the matched control subjects. Therefore, one should be careful interpreting REE versus predicted REE by equations for diagnosing hypermetabolism.…”

Section: Evaluation Of Hypermetabolismmentioning

confidence: 88%

“…10,16 In head and neck cancer, two studies have examined REE in combination with predicted REE by the Harris and Benedict equations. 17,18 Before radiotherapy, Garcia-Peris et al found higher measured REE than predicted REE, 17 whereas Silver et al 18 found no difference between measured and predicted REE before RT. Both studies showed elevated REE adjusted for fat free mass after RT, while a third study of Ng et al 5 showed a decrease in REE per kg fat free mass after RT.…”

Section: Introductionmentioning

confidence: 99%

Resting energy expenditure in head and neck cancer patients before and during radiotherapy

Langius¹,

Kruizenga²,

Uitdehaag³

et al. 2012

Clinical Nutrition

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“…The resting metabolic expenditure was found increased in 23% of patients [26] despite a condition of semistarvation and weight loss, and ranged between 17 and 30 kcal/kg/day [34].…”

Section: Introductionmentioning

confidence: 96%

Nutritional support in patients with oesophageal cancer

Bozzetti

2009

Support Care Cancer

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Prospective study of resting energy expenditure changes in head and neck cancer patients treated with chemoradiotherapy measured by indirect calorimetry

Cited by 45 publications

References 26 publications

A review of weight loss and sarcopenia in patients with head and neck cancer treated with chemoradiation

A review of weight loss and sarcopenia in patients with head and neck cancer treated with chemoradiation

Resting energy expenditure in head and neck cancer patients before and during radiotherapy

Nutritional support in patients with oesophageal cancer

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