BACKGROUND: Radiotherapy is an effective treatment for head and neck cancers but patients often experience side effects which lead to weight loss. Nutrition intervention in the form of counselling or oral nutrition support (ONS) is frequently needed for these patients. For some patients, tube feeding is required to minimise weight loss during treatment. METHOD: Data was collected on 48 patients who received radiotherapy to the head and neck region over a nine-month period (June 2009-March 2010). Retrospective data collection was commenced in July 2010. Each patient's Diet Therapy Department record was reviewed. Main outcome measures were: 1) type of nutrition support; 2) percentage weight change during treatment; and 3) Patient-Generated Subjective Global Assessment Global (PG-SGA) rating. RESULTS: On initial assessment 28 (77.8%) patients were classified as well nourished using the PG-SGA. Mean weight loss during radiotherapy was 5.74%. Risk factors for the need for ONS and enteral nutrition support (ENS) were older age, presence of nutrition impact symptoms, high-risk tumour sites, advanced disease and chemotherapy. No significant difference was shown in weight loss between ONS and ENS groups. CONCLUSION: This study identified the need for early dietetic intervention for high nutritional risk groups of head and neck cancer patients to prevent significant weight loss. Pre-treatment nutritional status did not influence weight loss during treatment. ONS alone cannot prevent significant weight loss in patients with multiple nutrition impact symptoms. Early enteral feeding should be considered in this group of patients.
BACKGROUND: Radiotherapy is an effective treatment for head and neck cancers but patients often experience side effects which lead to weight loss. Nutrition intervention in the form of counselling or oral nutrition support (ONS) is frequently needed for these patients. For some patients, tube feeding is required to minimise weight loss during treatment. METHOD: Data was collected on 48 patients who received radiotherapy to the head and neck region over a nine-month period (June 2009-March 2010). Retrospective data collection was commenced in July 2010. Each patient's Diet Therapy Department record was reviewed. Main outcome measures were: 1) type of nutrition support; 2) percentage weight change during treatment; and 3) Patient-Generated Subjective Global Assessment Global (PG-SGA) rating. RESULTS: On initial assessment 28 (77.8%) patients were classified as well nourished using the PG-SGA. Mean weight loss during radiotherapy was 5.74%. Risk factors for the need for ONS and enteral nutrition support (ENS) were older age, presence of nutrition impact symptoms, high-risk tumour sites, advanced disease and chemotherapy. No significant difference was shown in weight loss between ONS and ENS groups. CONCLUSION: This study identified the need for early dietetic intervention for high nutritional risk groups of head and neck cancerpatients to prevent significant weight loss. Pre-treatment nutritional status did not influence weight loss during treatment. ONS alone cannot prevent significant weight loss in patients with multiple nutrition impact symptoms. Early enteral feeding should be considered in this group of patients.
Entities:
Keywords:
Enteral nutrition; head and neck neoplasms; nutrition status; nutritional support
Authors: Alice Nourissat; Isabelle Bairati; Elodie Samson; André Fortin; Michel Gélinas; Abdenour Nabid; François Brochet; Bernard Têtu; François Meyer Journal: Cancer Date: 2010-05-01 Impact factor: 6.860
Authors: R G J Wiggenraad; L Flierman; A Goossens; R Brand; H P Verschuur; G A Croll; L E C Moser; R Vriesendorp Journal: Clin Otolaryngol Date: 2007-10 Impact factor: 2.597
Authors: Manon G A van den Berg; Ellen L Rasmussen-Conrad; Lillian van Nispen; Jaap J van Binsbergen; Matthias A W Merkx Journal: Oral Oncol Date: 2008-02-20 Impact factor: 5.337