Early nutritional intervention improves treatment tolerance and outcomes in head and neck cancer patients undergoing concurrent chemoradiotherapy

2009 ◽  
Vol 18 (7) ◽  
pp. 837-845 ◽  
Author(s):  
Agostino Paccagnella ◽  
Michela Morello ◽  
Maria C. Da Mosto ◽  
Carla Baruffi ◽  
Maria L. Marcon ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Concurrent Chemoradiotherapy ◽  
Nutritional Intervention ◽  
Treatment Tolerance

scholarly journals Nutritional management in head and neck cancer: United Kingdom National Multidisciplinary Guidelines

2016 ◽  
Vol 130 (S2) ◽  
pp. S32-S40 ◽  
Author(s):  
B Talwar ◽  
R Donnelly ◽  
R Skelly ◽  
M Donaldson
Keyword(s):  
Head And Neck Cancer ◽  
Nutritional Status ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Tube Feeding ◽  
Nutritional Intervention ◽  
Nutrition Support ◽  
Subjective Global Assessment ◽  
Chyle Leak

AbstractNutritional support and intervention is an integral component of head and neck cancer management. Patients can be malnourished at presentation, and the majority of patients undergoing treatment for head and neck cancer will need nutritional support. This paper summarises aspects of nutritional considerations for this patient group and provides recommendations for the practising clinician.Recommendations• A specialist dietitian should be part of the multidisciplinary team for treating head and neck cancer patients throughout the continuum of care as frequent dietetic contact has been shown to have enhanced outcomes. (R)• Patients with head and neck cancer should be nutritionally screened using a validated screening tool at diagnosis and then repeated at intervals through each stage of treatment. (R)• Patients at high risk should be referred to the dietitian for early intervention. (R)• Offer treatment for malnutrition and appropriate nutrition support without delay given the adverse impact on clinical, patient reported and financial outcomes. (R)• Use a validated nutrition assessment tool (e.g. scored Patient Generated–Subjective Global Assessment or Subjective Global Assessment) to assess nutritional status. (R)• Offer pre-treatment assessment prior to any treatment as intervention aims to improve, maintain or reduce decline in nutritional status of head and neck cancer patients who have malnutrition or are at risk of malnutrition. (G)• Patients identified as well-nourished at baseline but whose treatment may impact on their future nutritional status should receive dietetic assessment and intervention at any stage of the pathway. (G)• Aim for energy intakes of at least 30 kcal/kg/day. As energy requirements may be elevated post-operatively, monitor weight and adjust intake as required. (R)• Aim for energy and protein intakes of at least 30 kcal/kg/day and 1.2 g protein/kg/day in patients receiving radiotherapy or chemoradiotherapy. Patients should have their weight and nutritional intake monitored regularly to determine whether their energy requirements are being met. (R)• Perform nutritional assessment of cancer patients frequently. (G)• Initiate nutritional intervention early when deficits are detected. (G)• Integrate measures to modulate cancer cachexia changes into the nutritional management. (G)• Start nutritional therapy if undernutrition already exists or if it is anticipated that the patient will be unable to eat for more than 7 days. Enteral nutrition should also be started if an inadequate food intake (60 per cent of estimated energy expenditure) is anticipated for more than 10 days. (R)• Use standard polymeric feed. (G)• Consider gastrostomy insertion if long-term tube feeding is necessary (greater than four weeks). (R)• Monitor nutritional parameters regularly throughout the patient's cancer journey. (G)• Pre-operative:○ Patients with severe nutritional risk should receive nutrition support for 10–14 days prior to major surgery even if surgery has to be delayed. (R)○ Consider carbohydrate loading in patients undergoing head and neck surgery. (R)• Post-operative:○ Initiate tube feeding within 24 hours of surgery. (R)○ Consider early oral feeding after primary laryngectomy. (R)• Chyle Leak:○ Confirm chyle leak by analysis of drainage fluid for triglycerides and chylomicrons. (R)○ Commence nutritional intervention with fat free or medium chain triglyceride nutritional supplements either orally or via a feeding tube. (R)○ Consider parenteral nutrition in severe cases when drainage volume is consistently high. (G)• Weekly dietetic intervention is offered for all patients undergoing radiotherapy treatment to prevent weight loss, increase intake and reduce treatments interruptions. (R)• Offer prophylactic tube feeding as part of locally agreed guidelines, where oral nutrition is inadequate. (R)• Offer nutritional intervention (dietary counselling and/or supplements) for up to three months after treatment. (R)• Patients who have completed their rehabilitation and are disease free should be offered healthy eating advice as part of a health and wellbeing clinic. (G)• Quality of life parameters including nutritional and swallowing, should be measured at diagnosis and at regular intervals post-treatment. (G)

scholarly journals Analysis of thromboembolic events in head and neck cancer patients who underwent concurrent chemoradiotherapy with cisplatin: A real-world study

2021 ◽  
Author(s):  
Hundo Cho ◽  
Seok Yun Kang ◽  
Hyun Woo Lee ◽  
Yong Won Choi ◽  
Tae-Hwan Kim ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
General Population ◽  
Head And Neck ◽  
Cancer Patients ◽  
Incidence Rate ◽  
Neck Cancer ◽  
Real World ◽  
Concurrent Chemoradiotherapy ◽  
Thromboembolic Events ◽  
Factors Affecting

Abstract Background The risk of thromboembolic events (TEE) in cancer patients, especially those receiving cisplatin-based chemotherapy, is higher than that of general population. Methods The study investigated the incidence of TEE in 257 head and neck (H&N) cancer patients, during or within 6 months of completion of concurrent chemoradiotherapy (CCRT) with cisplatin, and analyzed factors affecting TEE occurrence. Results TEE occurred in 5 patients, an incidence rate of 1.9%. Khorana score was the only factor associated with TEE occurrence (p = 0.010). Conclusions The incidence of TEE in H&N cancer patients who underwent CCRT with cisplatin was relatively low when compared to other types of cancer. However, patients with a high Khorana score require more careful surveillance for possible TEE occurrence.

PO-1006 Nutritional intervention in head and neck cancer patients undergoing (chemo-)radiotherapy

2021 ◽  
Vol 161 ◽  
pp. S836-S837
Author(s):  
A. Löser ◽  
J. Abel ◽  
L. Kutz ◽  
A. Finger ◽  
F. Greinert ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Nutritional Intervention

Consensus and clinical recommendations for nutritional intervention for head and neck cancer patients undergoing chemoradiotherapy in Taiwan

Oral Oncology ◽  
2018 ◽  
Vol 81 ◽  
pp. 16-21 ◽  
Author(s):  
Mei-Chun Lin ◽  
Pei-Wei Shueng ◽  
Wei-Kuo Chang ◽  
Peter Mu-Hsin Chang ◽  
Hsin-Chun Feng ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Nutritional Intervention ◽  
Clinical Recommendations

P-43 Nutritional intervention in head and neck cancer patients during and after radiotherapy

Oral Oncology ◽  
2021 ◽  
Vol 118 ◽  
pp. 3-4
Author(s):  
Lucia Gutierrez Bayard ◽  
Raquel Rodriguez Sanchez ◽  
Sara Sayago Gil
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Nutritional Intervention
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