M González-Rodríguez1, R Villar-Taibo2, A Fernández-Pombo1, M Pazos-Couselo1,3, M A Sifontes-Dubón1, S Ferreiro-Fariña1, A Cantón-Blanco1, M A Martínez-Olmos1,3,4. 1. Endocrinology and Nutrition Department, Complejo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain. 2. Endocrinology and Nutrition Department, Complejo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain. rotaibo22@gmail.com. 3. Psychiatry, Radiology and Public Health Department, University of Santiago de Compostela, A Coruña, Spain. 4. CIBERObn, Instituto de Salud Carlos III, Madrid, Spain.
Abstract
BACKGROUND/ OBJECTIVES: Radiotherapy (RT) is a component of therapy for head and neck cancer (HNC) with a negative nutritional impact. Our aim was to compare an early versus a conventional nutritional intervention. SUBJECTS AND METHODS: Retrospective study of HNC patients undergoing RT. Evolution before and after the establishment of a fast-track circuit was evaluated. A conventional group (CG) made up of patients submitted to the nutrition unit during RT after nutritional deterioration, was compared to an early group (EG) represented by patients included in a fast-track circuit, starting nutritional follow-up before the beginning of RT. Only patients with preserved oral intake were involved. Demographic, nutritional and clinical variables were analyzed. Data of hospitalizations and deaths were collected up to three months after RT. RESULTS: 135 subjects constituted the EG and 39 the CG. At baseline, the prevalence of malnutrition was lower in the EG (31.9% vs 69.5%, p = 0.0001), as was the need for nutritional supplements (40% vs 79.5%, p = 0.0001) or nasogastric tube (0% vs 12.8%, p = 0.0001) in comparison to the CG. Three months after RT, there were less patients with oral nutritional support in the EG (79.1% vs 96.9%, p = 0.018), and the number of emergency visits (0.75 vs 1.1 episodes per patient, p = 0.021) and hospitalizations was also lower in this group (29% vs 59%, p = 0.044). CONCLUSIONS: The fast-track approach made early intervention possible. Therefore, patients maintained a better nutritional status, needed less nutritional support and their evolution improved, with a significant decrease in hospitalizations.
BACKGROUND/ OBJECTIVES: Radiotherapy (RT) is a component of therapy for head and neck cancer (HNC) with a negative nutritional impact. Our aim was to compare an early versus a conventional nutritional intervention. SUBJECTS AND METHODS: Retrospective study of HNC patients undergoing RT. Evolution before and after the establishment of a fast-track circuit was evaluated. A conventional group (CG) made up of patients submitted to the nutrition unit during RT after nutritional deterioration, was compared to an early group (EG) represented by patients included in a fast-track circuit, starting nutritional follow-up before the beginning of RT. Only patients with preserved oral intake were involved. Demographic, nutritional and clinical variables were analyzed. Data of hospitalizations and deaths were collected up to three months after RT. RESULTS: 135 subjects constituted the EG and 39 the CG. At baseline, the prevalence of malnutrition was lower in the EG (31.9% vs 69.5%, p = 0.0001), as was the need for nutritional supplements (40% vs 79.5%, p = 0.0001) or nasogastric tube (0% vs 12.8%, p = 0.0001) in comparison to the CG. Three months after RT, there were less patients with oral nutritional support in the EG (79.1% vs 96.9%, p = 0.018), and the number of emergency visits (0.75 vs 1.1 episodes per patient, p = 0.021) and hospitalizations was also lower in this group (29% vs 59%, p = 0.044). CONCLUSIONS: The fast-track approach made early intervention possible. Therefore, patients maintained a better nutritional status, needed less nutritional support and their evolution improved, with a significant decrease in hospitalizations.
Authors: J Alvarez; J Del Río; M Planas; P García Peris; A García de Lorenzo; V Calvo; G Olveira; J A Irles; G Piñeiro Journal: Nutr Hosp Date: 2008 Nov-Dec Impact factor: 1.057
Authors: María Rosa Alhambra Expósito; Aura D Herrera-Martínez; Gregorio Manzano García; María Espinosa Calvo; Carmen María Bueno Serrano; María Ángeles Gálvez Moreno Journal: Nutr Hosp Date: 2018-06-05 Impact factor: 1.057
Authors: Catherine Kubrak; Kärin Olson; Naresh Jha; Louise Jensen; Linda McCargar; Hadi Seikaly; Jeffery Harris; Rufus Scrimger; Matthew Parliament; Vickie E Baracos Journal: Head Neck Date: 2010-03 Impact factor: 3.147