Effect of early nutrition intervention on advanced nasopharyngeal carcinoma patients receiving chemoradiotherapy.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17504-e17504
Author(s):  
Lingbin Meng ◽  
Xiaochun Xu ◽  
Xin Jiang ◽  
Tarek Mekhail
Keyword(s):  
Weight Loss ◽  
Nasopharyngeal Carcinoma ◽  
Nutritional Status ◽  
Nutritional Intervention ◽  
Nutrition Intervention ◽  
Lower Percentage ◽  
Early Group ◽  
Early Nutrition ◽  
Treatment Tolerance ◽  
Late Group

e17504 Background: Patients with nasopharyngeal carcinoma (NPC) frequently developed the problem of malnutrition at the time of diagnosis. Chemoradiotherapy (CRT) can even worsen the situation. Therefore, nutritional intervention should be applied to prevent CRT-associated weight loss and interruption of CRT. However, it is still controversial if early nutritional intervention is beneficial to NPC patients with CRT. This study is to investigate the influence of early nutritional intervention on advanced NPC patients with CRT by evaluating the nutritional status and CRT treatment tolerance. Methods: A cohort of 78 stage III-IV nasopharyngeal carcinoma patients was divided into early (n = 46) and late (n = 32) nutrition intervention groups. The early group of patients received nutritional support at the beginning of CRT, whereas the late group received such a support until development of the side effects, like 50% required oral dietary intake or > 10% weight loss. The data were collected and statistically analyzed. Results: There was no significant difference in baseline clinical characteristics between these two groups, suggesting that no selection bias occurred. Both groups of patients had weight loss at the end of CRT and 3 months thereafter. However, at the later time point, the early group started to regain their weight, while the late group continued to lose weight. At both time points, the early group had a lower percentage of weight loss than the late group. Similar results were also obtained for BMI, albumin, and pre-albumin levels (All p< 0.05). Besides, the early group showed a lower rate of advanced mucositis, a lower percentage of patients with more than 3 days RT breaks, fewer days of RT delayed for toxicity, and a lower percentage of patients with unplanned hospitalizations (All p< 0.05). A linear correlation was also found between the percentage of weight loss and the number of days of RT delayed. Conclusions: Early nutritional intervention provides beneficial outcomes to NPC patients by maintaining their nutritional status and enhancing CRT treatment tolerance. Our results also indicated early nutrition intervention may reduce the hospital cost and improve patients’ life quality.

scholarly journals Effects of early nutritional intervention on oral mucositis in patients with radiotherapy for head and neck cancer

QJM ◽  
2019 ◽  
Vol 113 (1) ◽  
pp. 37-42
Author(s):  
J Wei ◽  
J Wu ◽  
L Meng ◽  
B Zhu ◽  
H Wang ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Enteral Nutrition ◽  
Nutritional Status ◽  
Oral Mucositis ◽  
Lymphocyte Count ◽  
Nutritional Intervention ◽  
Total Lymphocyte Count ◽  
High Grade ◽  
Early Group ◽  
Late Group

Summary Background To observe the effect of early nutritional intervention on radiation-induced oral mucositis and nutritional status in patients with head and neck cancer (HNC). Methods A total of 54 HNC patients were divided into early (28 cases) and late (26 cases) nutritional intervention groups. The early group received enteral nutrition at the beginning of radiotherapy (RT), while the late group received enteral nutrition after restricted feeding. Operators reported and assessed the timing and extent of oral mucositis and nutritional status during treatment. The nutritional status assessment indicators included body weight; body mass index (BMI); Patient-Generated–Subjective Global Assessment (PG-SGA) score; levels of albumin, hemoglobin and pre-albumin and total lymphocyte count. Results The incidence of high-grade oral mucositis was significantly lower in the early group than that in the late group (P &lt; 0.05). Nutritional status assessments showed more significant weight and BMI losses in the late group than in the early group at weeks 4 and 7 after RT (P &lt; 0.01). The albumin decreased in the late group at week 7 after RT was more significant than that in the early group (P &lt; 0.05). Albumin, hemoglobin and pre-albumin levels and total lymphocyte count decreased significantly in both groups (P &gt; 0.05). During therapy, more patients in the early group were well-nourished and fewer were malnourished according to PG-SGA scores (P &lt; 0.05). Conclusion Early nutritional intervention can reduce the incidence of high-grade oral mucositis during RT in patients with HNC and improve the nutritional status during treatment, which has important clinical significance.

Grazing behaviour and weight change of cattle turned out to pasture in spring

2003 ◽  
Vol 83 (4) ◽  
pp. 801-808 ◽  
Author(s):  
E. Charmley ◽  
R. W. Jannasch ◽  
J. Boyd
Keyword(s):  
Weight Loss ◽  
Weight Change ◽  
Dry Matter ◽  
The Other ◽  
Early Group ◽  
Initial Weight ◽  
Sward Height ◽  
Behavioural Patterns ◽  
Late Group ◽  
Grazing Behaviour

In the first of two trials, 20 Hereford steers were allocated to two adjacent 1.6-ha pastures on 29 May 1996. Steers in one pasture were given no supplement, while those in the other received supplemental silage each day. All steers on each treatment grazed their allocated paddock continuously for 28 d. Steers on pasture were weighed and their behaviour was monitored periodically throughout the 4 wk of grazing. The dry matter (DM) availability at turnout (651 kg hd-1) was considered in excess to requirement, since neither availability nor sward height declined over 28 d. In spite of this, steers lost 15 kg after turnout and took 12 d to regain their initial weight. There were no treatment effects. Nutrient composition of the sward changed in accordance with advancing maturity. Percent of time observed grazing (51%) did not change over the 28-d period; however, rumination time increased from around 10 to 30%. Grazing behaviour was similar for steers on both treatments. Silage intake averaged only 1.3 kg DM hd-1d-1. In 1997, 28 yearling steers were used in a 2 × 2 factorial design to study the effect of turnout date to pasture [21 May (E) vs. 4 June (L)] and supplemental silage feeding on weight change, grazing behaviour, pasture productivity and forage quality over 28 d. The DM availability at turnout was 391 kg hd-1. Available DM and sward height declined in both early and late treatments after turnout. The early group had to be removed from the trial after 16 d when sward height dropped below 4 cm. Sward quali ty after turnout declined only for the late group. Loss of body weight (BW) and days to regain initial BW after turnout were greater for early versus late steers. Steers ate only 0.5 kg silage DM hd-1d-1, but this reduced weight loss in late steers. Cattle turned out later spent less time grazing (P < 0.001 at 5 and 14 d) but no less time ruminating. Transient weight loss associated with turnout to pasture cannot be wholly explained by behavioural patterns. Other factors, such as altered ruminal conditions, must also play an important role. Key words: Pasture, steer performance, grazing behaviour, weight change

Does early oral feeding increase the likelihood of salivary fistula after total laryngectomy?

2014 ◽  
Vol 128 (4) ◽  
pp. 372-378 ◽  
Author(s):  
A A Sousa ◽  
J M Porcaro-Salles ◽  
J M A Soares ◽  
G M de Moraes ◽  
G S Silva ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Neck Dissection ◽  
Total Laryngectomy ◽  
Randomised Trial ◽  
Oral Feeding ◽  
Early Group ◽  
Salivary Fistula ◽  
Early Oral Feeding ◽  
Significant Difference ◽  
Late Group

AbstractObjective:This study compared the incidence of salivary fistula between groups with an early or late reintroduction of oral feeding, and identified the predictive factors for salivary fistula.Methods:A randomised trial was performed using 89 patients with larynx or hypopharynx cancer, assigned to 2 groups (early or late). In the early group, oral feeding was started 24 hours after total laryngectomy or total pharyngolaryngectomy, and in the late group, it was started from post-operative day 7 onwards. The occurrence of salivary fistula was evaluated in relation to the following variables: early or late oral feeding, nutritional status, cancer stage, surgery performed, and type of neck dissection.Results:The incidence of salivary fistula was 27.3 per cent (n = 12) in the early group and 13.3 per cent (n = 6) in the late group (p = 0.10). The following variables were not statistically significant: nutritional status (p = 0.45); tumour location (p = 0.37); type of surgery (p = 0.91) and type of neck dissection (p = 0.62). A significant difference (p = 0.02) between the free margins and invasive carcinoma was observed.Conclusion:The early reintroduction of oral feeding in total laryngectomised patients did not increase the incidence of salivary fistula.

scholarly journals Effect of Early Nutrition Intervention on Advanced Nasopharyngeal Carcinoma Patients Receiving Chemoradiotherapy

2019 ◽  
Vol 10 (16) ◽  
pp. 3650-3656 ◽  
Author(s):  
Lingbin Meng ◽  
Jinlong Wei ◽  
Rui Ji ◽  
Bin Wang ◽  
Xiaochun Xu ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Nutrition Intervention ◽  
Early Nutrition

scholarly journals Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 624
Author(s):  
Xiaojing Sharon Wu ◽  
Anna Miles ◽  
Andrea J. Braakhuis
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Nutritional Status ◽  
Outcome Measurement ◽  
Nutrition Intervention ◽  
Screening Tools ◽  
Food Services ◽  
Positive Effects ◽  
Ovid Medline ◽  
Systematic Database

While the association between dysphagia and malnutrition is well established, there is a lack of clarity regarding the nutritional status and mealtime satisfaction of those consuming texture-modified diets (TMDs). This systematic review summarises and critically appraises the nutritional status and mealtime satisfaction of adults consuming TMDs. A systematic database search following PICO criteria was conducted using Cochrane Central (via Ovid), MEDLINE, CINAHL, EMBASE and Scopus. Nutritional status, mealtime satisfaction and costs were identified as primary outcomes. Eligible studies were grouped according to outcome measurement. In total, 26 studies met the inclusion criteria. Twenty studies evaluated the nutritional status by weight change or using malnutrition screening tools and found the consumption of TMDs correlated with weight loss or malnutrition. Nine studies evaluated mealtime satisfaction, with two reporting poor satisfaction for people on thickened fluids (TFs). Nutrition intervention through adjusting texture and consistency and nutrition enrichment showed positive effects on weight and mealtime satisfaction. The majority of the studies were rated as ‘neutral’ quality due to the limited number of experiments. TMD consumers had compromised nutritional status and poor mealtime satisfaction. More research input is required to identify promising strategies for improving the nutritional status and mealtime satisfaction of this population. Food services need to consider texture, consistency and fortification in designing menus for people on TMDs to avoid weight loss and malnutrition, and to enhance mealtime enjoyment.

Enteral nutrition to improve nutritional status, treatment tolerance, and outcomes in patients with esophageal cancer undergoing concurrent chemoradiotherapy (CCRT): Results of a prospective, randomized, controlled, multicenter trial (NCT 02399306).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 4033-4033
Author(s):  
Tao Li ◽  
Jiahua Lv ◽  
Guangying Zhu ◽  
Jie Li ◽  
Shu chai Zhu ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Body Weight ◽  
Enteral Nutrition ◽  
Nutritional Status ◽  
Multicenter Trial ◽  
Nutrition Intervention ◽  
Control Group ◽  
Blood Parameter ◽  
Significant Difference ◽  
Treatment Tolerance

4033 Background: Patients with esophageal cancer undergoing CCRT are at high risk of malnutrition. The aim of this study was to investigate the influence of enteral nutrition on nutritional status, treatment tolerance and outcomes in esophageal cancer patients undergoing CCRT. Methods: Patients with inoperable esophageal cancer were randomly assigned (2:1 ratio) to the enteral nutrition group (EN group) or the control group. Patients in the EN group were supported with individual enteral nutrition intervention according to the nutritional status assessment results. The control group was treated with conventional diet guidance. The primary endpoint was the change in body weight from baseline after treatment. Secondary endpoints were nutrition related blood parameter changes, treatment tolerance and outcomes. Results: Between Mar. 2015 and Jan. 2017, 158 patients from ten hospitals were randomised into the EN group (n = 106) and the control group (n = 52). Following CCRT, patients in EN group lost only 0.72±3.27 kg of body weight compared with 2.10±2.89 kg in the control group (P < 0.001). Participants who received EN had less decline than controls in serum albumin (2.66±5.05 g/L and 4.75±4.94 g/L, P < 0.001) and hemoglobin (10.29±15.78 g/L and 18.48±14.66 g/L, P < 0.001). Grade 3/4 leukopenia in the control group was significantly more frequent than the EN group (33.3% vs. 20.0 %, P = 0.011). Patients supported on EN experienced greater chemoradiotherapy completion rates (92.5% vs. 67.3%, P = 0.001) and lower infection rates (18.8% vs 31.7%, P = 0.021). There was significant difference in tumor response between two groups (EN group: 81.1%, control group: 67.3%, P = 0.004). The 1- and 2-year OS rates in the EN group were significantly greater (89.6% and 75.4%, respectively) compared with the control group (78.5% and 57.9%, respectively). Conclusions: Enteral nutrition may be advantageous in patients with esophageal cancer undergoing CCRT by improving nutritional status, treatment tolerance and outcomes. Clinical trial information: NCT 02399306.

Do most newly diagnosed advanced NSCLC patients need nutritional intervention?

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9108-9108
Author(s):  
N. Swinton ◽  
G. Kasymjanova ◽  
T. Steinberg ◽  
L. Lajeunesse ◽  
E. Dajczman ◽  
...  
Keyword(s):  
Weight Loss ◽  
Screening Tool ◽  
Advanced Nsclc ◽  
Inflammatory Marker ◽  
Symptom Control ◽  
Nutritional Intervention ◽  
Nutrition Intervention ◽  
Newly Diagnosed ◽  
Taste Changes ◽  
Nsclc Patients

9108 Background: Depletion of nutritional reserves and significant weight loss are commonly noted in patients (pts) with non-small cell lung cancer (NSCLC). The Patient Generated Subjective Global Assessment (PG-SGA) is a nutritional screening tool for cancer pts, recommended by the Oncology Network of Dietitians of Canada and the American Dietetic Association. The PG-SGA categorizes total scores into 4 ranges for nutritional triage: 0–1 requires no intervention, 2–3 requires education, 4 - 8 requires intervention by a dietitian, and =9 requires urgent symptom control and nutrition intervention. (Ottery, 2000). Methods: We determined the prevalence of malnutrition in 92 newly diagnosed advanced NSCLC pts (stages 3 / 4) in an outpatient clinic who had completed a baseline PG-SGA. We also investigated the association between CRP (an inflammatory marker which correlates with poor prognosis) and the PG-SGA. PG-SGA score was based on the sum of 4 subscales: symptoms, weight history, food intake and functional status. Results: 92 pts (M 48, F 44) aged 65 ±11 years were studied. 21 (23%) pts had a PG-SGA score of 0–3, 23 (25%) 4–8, and 48 (52%) of 9 or greater. The most common symptoms accounting for a high PG-SGA score were: no appetite 37 (40%), pain 27 (29%), constipation 26 (28%), feeling full 24 (26%), dry mouth 22 (24%) and taste changes 19 (21%). 51 (55%) pts lost 0–4.9% of their body weight in the past month, 17 (19%) had a weight loss of 5–9.9% and 24 (26%) had a weight loss =10 %. In pts with a PG-SGA score of 0–3 the median CRP was 7.0 mg/L (range: 0.7–66.0), in those with a score of 4–8 the median CRP was 41.8 mg/L (0.8–266.1) and in those with a score of =9 the median CRP was 18.5 mg/L (0.3–219.0) (p=0.02). Conclusion: At time of diagnosis, 77% of advanced NSCLC pts were in need of nutritional intervention; 52% required urgent intervention. The PG-SGA is a simple screening tool which should be incorporated into patient care in outpatient oncology clinics. No significant financial relationships to disclose.

scholarly journals The Impact of Human Papillomavirus (HPV) Associated Oropharyngeal Squamous Cell Carcinoma (OPSCC) on Nutritional Outcomes

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 514
Author(s):  
Jane Harrowfield ◽  
Elizabeth Isenring ◽  
Nicole Kiss ◽  
Erin Laing ◽  
Ruby Lipson-Smith ◽  
...  
Keyword(s):  
Weight Loss ◽  
Squamous Cell Carcinoma ◽  
Human Papillomavirus ◽  
Nutritional Status ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Nutritional Intervention ◽  
Oropharyngeal Squamous Cell Carcinoma ◽  
Post Treatment ◽  
Nutritional Outcomes

Background: Patients undergoing (chemo) radiotherapy for oropharyngeal squamous cell carcinoma (OPSCC) are at high risk of malnutrition during and after treatment. Malnutrition can lead to poor tolerance to treatment, treatment interruptions, poor quality of life (QOL) and potentially reduced survival rate. Human papillomavirus (HPV) is now known as the major cause of OPSCC. However, research regarding its effect on nutritional outcomes is limited. The aim of this study was to examine the relationship between HPV status and nutritional outcomes, including malnutrition and weight loss during and after patients’ (chemo) radiotherapy treatment for OPSCC. Methods: This was a longitudinal cohort study comparing the nutritional outcomes of HPV-positive and negative OPSCC patients undergoing (chemo) radiotherapy. The primary outcome was nutritional status as measured using the Patient Generated-Subjective Global Assessment (PG-SGA). Secondary outcomes included loss of weight, depression, QOL and adverse events. Results: Although HPV-positive were less likely to be malnourished according to PG-SGA at the beginning of treatment, we found that the difference between malnutrition rates in response to treatment was not significantly different over the course of radiotherapy and 3 months post treatment. HPV-positive participants had significantly higher odds of experiencing >10% weight loss at three months post-treatment than HPV-negative participants (OR = 49.68, 95% CI (2.7, 912.86) p ≤ 0.01). Conclusions: The nutritional status of HPV positive and negative patients were both negatively affected by treatment and require similarly intense nutritional intervention. In acute recovery, HPV positive patients may require more intense intervention. At 3- months post treatment, both groups still showed nutritional symptoms that require nutritional intervention so ongoing nutritional support is essential.

scholarly journals An Earlier First Meal Timing Associate with Weight Loss Effectiveness in A 12-Week Weight Loss Support Program

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 249
Author(s):  
Mana Hatanaka ◽  
Yoichi Hatamoto ◽  
Eri Tajiri ◽  
Naoyuki Matsumoto ◽  
Shigeho Tanaka ◽  
...  
Keyword(s):  
Weight Loss ◽  
Loss Rate ◽  
Support Program ◽  
Weight Loss Intervention ◽  
Early Group ◽  
Weight Loss Rate ◽  
Change Rate ◽  
Meal Timing ◽  
The Relationship ◽  
Late Group

Recent studies have reported that meal timing may play an important role in weight regulation, however it is unknown whether the timing of meals is related to the amount of weight loss. This study aimed to examine the relationship between indices of meal timing and weight loss during weight loss intervention in adults. A 12-week weight loss support program was conducted for 97 adults (age: 47.6 ± 8.3 years, BMI: 25.4 ± 3.7 kg/m2). After the program, body weight decreased by −3.0 ± 2.7%. Only the start of the eating window was positively correlated with the weight change rate in both sexes (men: r = 0.321, p = 0.022; women: r = 0.360, p = 0.014). The participants were divided into two groups based on the start of the eating window as follows: the early group (6:48 ± 0:21 AM) and the late group (8:11 ± 1:05 AM). The weight loss rate in the early group was significantly higher (−3.8 ± 2.7%) than that in the late group (−2.2 ± 2.5%). The present results showed that the start of the early eating window was associated with weight loss and suggested paying attention to meal timing when doing weight loss.

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