scholarly journals The Effects of Early Nutritional Intervention on Oral Mucositis and Nutritional Status of Patients With Head and Neck Cancer Treated With Radiotherapy

2021 ◽  
Vol 10 ◽  
Author(s):  
Zhuangzhuang Zheng ◽  
Xin Zhao ◽  
Qin Zhao ◽  
Yuyu Zhang ◽  
Shiyu Liu ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Nutritional Status ◽  
Head And Neck ◽  
Neck Cancer ◽  
Oral Mucositis ◽  
Intervention Strategy ◽  
Nutritional Intervention ◽  
Assessment Tools ◽  
Common Side Effect ◽  
Clinical Factor

Radiation-induced oral mucositis (RIOM) is a common side effect after radiotherapy (RT) in head and neck cancer (HNC) patients. RIOM patients with severe pain have difficulty in eating, which increases the incidence of malnutrition and affects patients’ quality of life and the process of RT. The mechanism of RIOM is not fully understood, and inflammatory response and oxidative stress appear to be important for RIOM occurrence and development. The nutritional status of patients is very important for their RT tolerance and recovery. Malnutrition, which can lead to anemia, low protein, decreased immunity and other problems, is an important clinical factor affecting tumor progression and treatment. Recent studies have shown that early nutritional intervention can ameliorate oral mucositis and nutritional status of patients with HNC. However, in clinical practice, early nutritional intervention for patients with HNC is not a conventional intervention strategy. Therefore, this review summarized the possible pathogenesis of RIOM, commonly used assessment tools for malnutrition in patients, and recent studies on the effects of early nutritional interventions on RIOM and nutritional status of patients with HNC. We hope to provide the basis and reference for the clinical application of early nutritional intervention models.

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 Acute radiation-induced oral mucositis in patients subjected to radiotherapy due to head and neck cancer

2019 ◽  
Vol 129 (1) ◽  
pp. 27-30 ◽  
Author(s):  
Anna Brzozowska ◽  
Paweł Gołębiowski
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Oral Mucositis ◽  
Systemic Infection ◽  
Cost Of Care ◽  
Common Side Effect ◽  
Proven Efficacy ◽  
Radiation Induced ◽  
Severe Oral Mucositis

Abstract Oral mucositis is a common side effect of radiation therapy for head and neck cancer. Severe mucositis is followed by symptoms, such as extreme pain, mucosal ulceration and consequent limitations in swallowing and achieving adequate nutritional intake. Mucositis may also increase the risk of local and systemic infection and significantly affect quality of life and cost of care. Severe oral mucositis can lead to the need to interrupt or discontinue cancer therapy and thus may have an impact on cure of the primary disease. In spite of all the advances made in understanding the pathophysiology of oral mucositis, there is still no prophylactic therapy with proven efficacy and known risk factors. This review will discuss oral mucositis epidemiology, impact and side effects, pathogenesis, scoring scales and prevention.

Nutritional status as a prognostic factor in advanced head and neck cancer

1998 ◽  
Vol 23 (4) ◽  
pp. 376-376
Author(s):  
Quak ◽  
Van Bokhorst ◽  
Klop ◽  
Van Leeuwen ◽  
Snow
Keyword(s):  
Head And Neck Cancer ◽  
Prognostic Factor ◽  
Nutritional Status ◽  
Head And Neck ◽  
Neck Cancer ◽  
Advanced Head

Prognosis in Head and Neck Cancer: Importance of Nutritional and Biological Inflammatory Status

2021 ◽  
pp. 019459982110045
Author(s):  
Nicolas Saroul ◽  
Mathilde Puechmaille ◽  
Céline Lambert ◽  
Achraf Sayed Hassan ◽  
Julian Biau ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Prognostic Factors ◽  
Inflammatory Response ◽  
Nutritional Status ◽  
Head And Neck ◽  
Neck Cancer ◽  
Risk Index ◽  
Nutritional Risk ◽  
Inflammatory Status ◽  
Nutritional Risk Index

Objectives To determine the importance of nutritional status, social status, and inflammatory status in the prognosis of head and neck cancer. Study Design Single-center retrospective study of prospectively collected data. Setting Tertiary referral center. Methods Ninety-two consecutive patients newly diagnosed for cancer of the upper aerodigestive tract without metastases were assessed at time of diagnosis for several prognostic factors. Nutritional status was assessed by the nutritional risk index, social status by the EPICES score, and inflammatory status by the systemic inflammatory response index. The primary endpoint was overall survival. Results In multivariable analysis, the main prognostic factors were the TNM classification (hazard ratio [HR] = 3.34, P = .002, for stage T3-4), malnutrition as assessed by the nutritional risk index (HR = 3.64, P = .008, for severe malnutrition), and a systemic inflammatory response index score ≥1.6 (HR = 3.32, P = .02). Social deprivation was not a prognostic factor. Conclusion Prognosis in head and neck cancer is multifactorial; however, malnutrition and inflammation are important factors that are potentially reversible by early intervention.

scholarly journals Incidence of Oral Mucositis in Patients Undergoing Head and Neck Cancer Treatment: Systematic Review and Meta-Analysis

2021 ◽  
Vol 5 (1) ◽  
pp. 23
Author(s):  
Raquel Pacheco ◽  
Maria Alzira Cavacas ◽  
Paulo Mascarenhas ◽  
Pedro Oliveira ◽  
Carlos Zagalo
Keyword(s):  
Systematic Review ◽  
Head And Neck Cancer ◽  
Oral Health ◽  
Cancer Treatment ◽  
Head And Neck ◽  
Neck Cancer ◽  
Oral Mucositis ◽  
Negative Impact ◽  
Meta Analysis ◽  
Incidence Rates

This systematic review and meta-analysis aimed to assess the literature about the incidence of oral mucositis and its degrees (mild, moderate, and severe), in patients undergoing head and neck cancer treatment (radiotherapy, chemotherapy, and surgery). Addressing this issue is important since oral mucositis has a negative impact on oral health and significantly deteriorates the quality of life. Therefore, a multidisciplinary team, including dentists, should be involved in the treatment. The overall oral mucositis incidence was 89.4%. The global incidence for mild, moderate, and severe degrees were 16.8%, 34.5%, and 26.4%, respectively. The high incidence rates reported in this review point out the need for greater care in terms of the oral health of these patients.

Do grape and black mulberry molasses have an effect on oral mucositis and quality of life in patients with head and neck cancer?

2021 ◽  
Author(s):  
Sezin Yuce Sari ◽  
Caglayan Selenge Beduk Esen ◽  
Gozde Yazici ◽  
Deniz Yuce ◽  
Mustafa Cengiz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Oral Mucositis
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