Nutritional status and dietary quality index of head and neck cancer patients undergoing chemo radiotherapy

Introduction: Considering the important role of early detection of malnutrition in patients with cancer and its negative effects on the outcome, as well as the lack of any published article (to the best of our knowledge) about the dietary quality index in head and neck cancer patients treated with chemoradio therapy, we decided to evaluate the nutritional status and dietary quality index in these patients. Methods: In this study, thirty-seven volunteer patients with head and neck cancer were recruited. Nutritional status of the patients was evaluated by Mini Nutritional Assessment (MNA) questionnaire. Dietary diversity score, dietary variety score, and diet quality index–international were calculated to assess the dietary quality of the patients. Results: Our findings indicated that about half of the patients were well nourished and 48.6%were at the risk of malnutrition. We did not find any significant differences between variousdietary quality indices and nutritional status of the patients. However, a significant reverse correlation was observed between dietary quality indices and nutritional status of the patients. Conclusion: According to our findings, the evaluation of nutritional status and the prediction of the patients at higher risks of chemoradio therapy-induced adverse events, may have a major role in the prevention of treatment gaps.

Download Full-text

Elective gastrostomy, nutritional status and quality of life in advanced head and neck cancer patients receiving chemoradiotherapy

ANZ Journal of Surgery ◽

10.1111/j.1445-2197.2009.05056.x ◽

2009 ◽

Vol 79 (10) ◽

pp. 713-718 ◽

Cited By ~ 45

Author(s):

Randall P. Morton ◽

Victoria L. Crowder ◽

Robert Mawdsley ◽

Esther Ong ◽

Mark Izzard

Keyword(s):

Quality Of Life ◽

Head And Neck Cancer ◽

Nutritional Status ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Advanced Head

Download Full-text

Association Between Preoperative Nutritional Status and Postoperative Outcome in Head and Neck Cancer Patients

Nutrition and Cancer ◽

10.1080/01635581.2017.1285406 ◽

2017 ◽

Vol 69 (3) ◽

pp. 464-469 ◽

Cited By ~ 21

Author(s):

John S. L. Leung ◽

Alfred Seto ◽

George K. H. Li

Keyword(s):

Head And Neck Cancer ◽

Nutritional Status ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Postoperative Outcome

Download Full-text

Alleviation of dry mouth by saliva substitutes improved swallowing ability and clinical nutritional status of post-radiotherapy head and neck cancer patients: a randomized controlled trial

Supportive Care in Cancer ◽

10.1007/s00520-019-05132-1 ◽

2019 ◽

Vol 28 (6) ◽

pp. 2817-2828 ◽

Cited By ~ 2

Author(s):

Sumalee Nuchit ◽

Aroonwan Lam-ubol ◽

Wannaporn Paemuang ◽

Sineepat Talungchit ◽

Orapin Chokchaitam ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Head And Neck Cancer ◽

Nutritional Status ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Controlled Trial ◽

Dry Mouth ◽

Randomized Controlled ◽

Saliva Substitutes

Abstract Purpose The aim of this study is to investigate the effect of an edible saliva substitute, oral moisturizing jelly (OMJ), and a topical saliva gel (GC) on dry mouth, swallowing ability, and nutritional status in post-radiotherapy head and neck cancer patients. Methods Sixty-two post-radiation head and neck cancer patients with xerostomia completed a blinded randomized controlled trial. They were advised to swallow OMJ (n = 31) or apply GC orally (n = 31) for 2 months. Outcome measures were assessed at baseline, 1, and 2 months, including subjective and objective dry mouth (Challcombe) scores, subjective swallowing problem scores (EAT-10), water swallowing time, clinical nutritional status (PG-SGA), body weight, and dietary intake. Results After 1 and 2 months of interventions, subjective and objective dry mouth scores, subjective swallowing problem scores, swallowing times, and clinical nutritional status in both groups were significantly improved (p < 0.0001). Compared to GC, OMJ group had higher percent improvement in all outcome measures (p < 0.001) except swallowing time and clinical nutritional status. Interestingly, subjective dry mouth scores were significantly correlated with subjective swallowing problem scores (r = 0.5321, p < 0.0001). Conclusions Continuous uses of saliva substitutes (OMJ or GC) for at least a month improved signs and symptoms of dry mouth and enhanced swallowing ability. An edible saliva substitute was superior to a topical saliva gel for alleviating dry mouth and swallow problems. These lead to improved clinical nutritional status. Thus, palliation of dry mouth may be critical to support nutrition of post-radiotherapy head and neck cancer patients. Clinical trial registry Clinicaltrials.gov NCT03035825

Download Full-text

A clinical audit of the nutritional status and need for nutrition support amongst head and neck cancer patients treated with radiotherapy

Australasian Medical Journal ◽

10.4066/amj.2012.910 ◽

2012 ◽

Vol 5 (1) ◽

pp. 8-13 ◽

Cited By ~ 8

Author(s):

E Jeffery

Keyword(s):

Head And Neck Cancer ◽

Nutritional Status ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Clinical Audit ◽

Nutrition Support

Download Full-text

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215116000402 ◽

2016 ◽

Vol 130 (S2) ◽

pp. S32-S40 ◽

Cited By ~ 70

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)

Download Full-text