scholarly journals Oral Nutritional Supplementation Affects the Dietary Intake and Body Weight of Head and Neck Cancer Patients during (Chemo) Radiotherapy

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2516 ◽  
Author(s):  
Isabela Borges Ferreira ◽  
Emanuelle do Nascimento Santos Lima ◽  
Paula Philbert Lajolo Canto ◽  
Cristiana Araújo Gontijo ◽  
Yara Cristina de Paiva Maia ◽  
...  
Keyword(s):  
Body Weight ◽  
Head And Neck Cancer ◽  
Dietary Intake ◽  
Head And Neck ◽  
Neck Cancer ◽  
Treatment Time ◽  
Nutritional Supplementation ◽  
Weight Changes ◽  
Micronutrient Intake ◽  
Calcium Magnesium

Considering the symptoms of (chemo) radiotherapy and the reduction in food intake in head and neck cancer (HNC) patients, this study aimed to investigate the association between treatment time points and oral nutritional supplementation (ONS) on dietary intake to estimate the frequency of energy and nutrient inadequacy, and also to evaluate body weight changes (BWC). Dietary intake data of 65 patients were obtained from 24-h dietary recalls and prevalence of inadequacy was calculated before or at the beginning (T0), in the middle (T1), and at the end of treatment (T2). BWC were calculated as the weight difference considering the previous weight reported and/or measured. Energy and macronutrient intake decreased in T1 and then improved in T2 (p < 0.001 for both). Micronutrient intake increased during treatment due to ONS use, but still presented a high probability of inadequate intake. In particular, calcium, magnesium, and vitamin B6 showed almost 100% of probability of inadequacy for those who did not use ONS. Finally, overweight patients suffered a higher weight accumulated deficit with a delta of −15 kg compared to other BMI (body mass index) categories. Therefore, we strongly recommend initiating nutritional counseling in conjunction with prophylactic ONS prescription from diagnosis to adjust nutrient intake and minimize weight loss.

Quality of Life of Patients with Head and Neck Cancer Receiving Cetuximab, Fluorouracil, Cisplatin Comparing to Cetuximab, Fluorouracil, Cisplatin and Docetaxel within the CEFCID Trial

2021 ◽  
Author(s):  
Ute Goerling ◽  
Thomas Gauler ◽  
Andreas Dietz ◽  
Viktor Grünwald ◽  
Stephan Knipping ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Treatment Time ◽  
Life Questionnaire ◽  
European Organization ◽  
Global Quality Of Life ◽  
The Impact

Introduction: CeFCiD was a multicenter phase II study comparing the efficacy of cetuximab, 5-flourouracil, cisplatin with the same regimen adding docetaxel in recurrent/metastatic head and neck cancer. The primary analysis trial did not demonstrate survival benefit from therapy intensification in first-line recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN). The current analysis of the trial assessed the impact of treatment on quality of life (QoL). Methods: The European Organization for Research and Treatment of Cancer Quality of life Questionnaire QLQ-C30 and the tumor specific module for head and neck cancer (QLQ-H&N35) were used to assess QoL at baseline (visit 1), after 2 (visit 3), 4 (visit 5), and 6 (visit 7) cycles of chemotherapy. Results: Of 180 patients included in this study, 86 patients (47.8%) completed the questionnaires at baseline. Considering selected scores over treatment time, there was no difference in global quality of life, dyspnea, swallowing and speech between the treatment arms in the course. For fatigue a significant increase from baseline to visit 3 (p=0.02), visit 5 (p=0.002), and to visit 7 (p=0.003) was observed for patients receiving docetaxel (D), cisplatin or carboplatin (P), 5-FU (F) and cetuximab (C). At the end of chemotherapy the manifestation of fatigue was similar compared in the two treatment arms. Discussion/Conclusion: Therapy intensification not adversely affect selected scores of QoL of patients with recurrent and/or metastatic SCCHN. Nevertheless, fatigue seems to be pronounced in patients treated with docetaxel.

Abstract A86: Higher micronutrient intake is associated with human papillomavirus-positive head and neck cancer: A case-only analysis

2010 ◽  
Author(s):  
Anna E. Arthur ◽  
Sonia A. Duffy ◽  
Gloria I. Sanchez ◽  
Stephen B. Gruber ◽  
Jeffrey E. Terrell ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Human Papillomavirus ◽  
Head And Neck ◽  
Neck Cancer ◽  
Micronutrient Intake

scholarly journals Reducing Referral-to-Treatment Waiting Times in Cancer Patients Using a Multidisciplinary Database

2007 ◽  
Vol 89 (2) ◽  
pp. 113-117 ◽  
Author(s):  
SAR Nouraei ◽  
J Philpott ◽  
SM Nouraei ◽  
DCK Maude ◽  
GS Sandhu ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Treatment Planning ◽  
Neck Cancer ◽  
Treatment Time ◽  
Waiting Times ◽  
Multidisciplinary Teams ◽  
Number Of Patients ◽  
Cancer Plan

INTRODUCTION Modern delivery of cancer care through patient-centred multidisciplinary teams (MDT) has improved survival. This approach, however, requires effective on-going co-ordination between multiple specialties and resources and can present formidable organisational challenges. The aim of this study was to improve the efficiency of the MDT process for head and neck cancer. PATIENTS AND METHODS A systems analysis of the MDT process was undertaken to identify bottlenecks delaying treatment planning. The MDT process was then audited. A revised process was developed and an Intranet-based data management solution was designed and implemented. The MDT process was re-evaluated to complete the audit cycle. RESULTS We designed and implemented a trust-wide menu-driven database with interfaces for registering and tracking patients, and automated worklists for pathology and radiology. We audited our MDT for 11 and 10 weeks before and following the introduction of the database, with 226 and 187 patients being discussed during each period. The database significantly improved cross-specialtity co-ordination, leading to a highly significant reduction in the number of patients whose treatment planning was delayed due to unavailability of adjunctive investigations (P < 0.001). This improved the overall efficiency of the MDT by 60%. CONCLUSIONS The NHS Cancer Plan aspires to reduce the referral-to-treatment time to 1 month. We have shown that a simple, trust-wide database reduces treatment planning delays in a sizeable proportion of head and neck cancer patients with minimal resource implications. This approach could easily be applied in other MDT meetings.

Body composition and dietary intake in patients with head and neck cancer during radiotherapy: a longitudinal study

2020 ◽  
pp. bmjspcare-2020-002359
Author(s):  
Bing Zhuang ◽  
Lichuan Zhang ◽  
Yujie Wang ◽  
Yiwei Cao ◽  
Yian Shih ◽  
...  
Keyword(s):  
Body Composition ◽  
Head And Neck Cancer ◽  
Dietary Intake ◽  
Head And Neck ◽  
Energy Intake ◽  
Neck Cancer ◽  
High Energy ◽  
The Body ◽  
Fat Free Mass ◽  
Prospective Longitudinal

ObjectivesTo investigate the body composition and dietary intake in the patients with head and neck cancer (HNC) during radiotherapy (RT), and explore the relationship between them.MethodsThis was a prospective, longitudinal observational study. Adult patients with HNC undergoing RT between March 2017 and August 2018 were recruited. Patients’ body compositions were evaluated by bioelectrical impedance analysis, and dietary intake was recorded by 24-hour dietary recall at three time points, including baseline (T1), mid-treatment (T2) and post-treatment (T3). Patients were divided into low, middle and high energy intake groups based on the average daily energy intake (DEI). Changes in body weight (BW), fat mass (FM), fat-free mass (FFM) and skeletal muscle mass (SMM) among these three groups were compared.ResultsFrom T1 to T3, the median loss of patients’ BW, FM, FFM and SMM was 4.60, 1.90, 2.60 and 1.50 kg, respectively. The loss of BW was more dramatic from T2 to T3 than that from T1 to T2. BW loss was mainly contributed by SMM loss from T1 to T2 and by FM loss from T2 to T3. Meanwhile, patients’ dietary intake reduced during treatment. High DEI group had a significantly attenuated loss of patients’ BW, FFM, SMM and FM compared with the low DEI group.ConclusionPatients’ BW, FM, FFM and SMM all significantly reduced, especially from T2 to T3, with decreased DEI during RT, which stresses the importance of nutrition intervention during the whole course of RT.

scholarly journals Exploration of risk factors for weight loss in head and neck cancer patients

2015 ◽  
Vol 14 (4) ◽  
pp. 343-352 ◽  
Author(s):  
Patrick Dawson ◽  
Amy Taylor ◽  
Chris Bragg
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Weight Loss ◽  
Body Weight ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Linear Regression Analysis ◽  
Relative Significance

AbstractIntroductionHead and neck cancer patients receiving radiotherapy can experience a number of toxicities, including weight loss and malnutrition, which can impact upon the quality of treatment. The purpose of this retrospective cohort study is to evaluate weight loss and identify predictive factors for this patient group.Materials and methodsA total of 40 patients treated with radiotherapy since 2012 at the study centre were selected for analysis. Data were collected from patient records. The association between potential risk factors and weight loss was investigated.ResultsMean weight loss was 5 kg (6%). In all, 24 patients lost >5% starting body weight. Age, T-stage, N-stage, chemotherapy and starting body weight were individually associated with significant differences in weight loss. On multiple linear regression analysis age and nodal status were predictive.ConclusionYounger patients and those with nodal disease were most at risk of weight loss. Other studies have identified the same risk factors along with several other variables. The relative significance of each along with a number of other potential factors is yet to be fully understood. Further research is required to help identify patients most at risk of weight loss; and assess interventions aimed at preventing weight loss and malnutrition.

A novel multiple-catheter implantation method for advanced head and neck cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 6582-6582
Author(s):  
Masatoshi Ohmae ◽  
Itsuro Kato ◽  
Yusei Fujita ◽  
Noritoshi Meshii ◽  
Ayako Motoki ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Treatment Time ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Occipital Artery ◽  
Partial Responder ◽  
Catheter Implantation ◽  
Implantation Method

6582 Background: We previously developed a super-selective intra-arterial chemotherapy (iaCT) approach for head and neck cancer (HNC), by which, an intra-arterial catheter is retrogradely inserted via either the superficial temporal artery (STA) or occipital artery (OA) and connected to a subcutaneous reservoir. As a result, since this approach overcomes the need for frequent fluoroscopy sessions, the infusion frequency can be increased and the therapeutic effectiveness improved. However, since the anticancer effect is limited to the region supplied by the selected blood vessel, it is often difficult to control an advanced HNC by single-catheter iaCT. Subsequently, a novel multiple-catheter implantation method (MCIM) for super-selective iaCT has been developed using, both, the STA and OA. Methods: A total of 21 patients with stage III or IV HNC were enrolled in this study and treated via MCIM for iaCT between 2009 and 2017. The catheters were super-selectively placed in the tumor-feeding arteries after having entered the STA or OA. The first catheter was introduced into one of the target branches. Next, a second catheter was introduced into another target branch. If a third catheter was required, the procedure was repeated. The extra-arterial portions of the catheters were subcutaneously connected to an implanted juxta-mastoidal infusion reservoir. Results: The response rate was 100%; particularly, 20 cases of complete response and 1 of partial response were confirmed. Although the partial responder underwent salvage surgery and two complete responders ultimately died (due to either delayed recurrence or brain metastases), the other 18 patients have been living cancer-free for 2-9 years. Conclusions: The MCIM method allows to expand the infusion region while maintaining the main advantages of super-selective iaCT. As a consequence, due to the lack of need for patient confinement in the catheter room and for frequent fluoroscopy sessions, patients’ mental and physical distress, medical expenses, and treatment time are all ultimately reduced.

scholarly journals Dosimetric comparison of radiotherapy treatment plans done by IMRT and VMAT technique in head and neck cancer patients

2021 ◽  
Vol 9 (3) ◽  
pp. 167-171
Author(s):  
Dr. Aparajeeta Aparajeeta ◽  
◽  
Dr. Ankita Mehta ◽  
Mr. N.S. Silambarasan ◽  
Dr. Piyush Kumar ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Treatment Time ◽  
Statistical Significance ◽  
Target Volume ◽  
Treatment Delivery ◽  
Patient Load ◽  
Treatment Plans

Background: The increasing patient load in radiotherapy centres demands selection of thetechnique that provides plans with optimal dosimetry in terms of target volume coverage, organs atrisk (OAR) sparing and a lesser treatment time. This study was designed to compare the two widelypractised conformal techniques, IMRT and VMAT in head and neck cancer patients in terms ofplanning target volume (PTV) coverage, OAR sparing and treatment delivery parameters. Materialsand methods: For ten postoperative head and neck cancer patients who had been treated by IMRTtechnique virtual VMAT plans were generated for study purposes. The dose prescribed to PTV was 60Gy in 30 fractions. The dose-volume parameters of PTV and OARs and the treatment deliveryparameters were compared amongst both the techniques. Statistical significance was calculatedusing paired ‘t’ test. Results: Both the plans were comparable in terms of dosimetry. The onlysignificant difference being better conformity in the IMRT plans. The dose to OARs was alsocomparable in both the techniques except for a significant reduction in the point dose to brainstemwith the IMRT technique. Given the treatment delivery parameters, there was a significant reductionin the treatment delivery time and monitor units with the VMAT technique compared to the IMRTtechnique. Conclusion: VMAT technique gave comparable plans to that of the IMRT technique interms of dosimetry but reduced the treatment time. It seems feasible in radiotherapy centres withincreased patient load.

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