Linda A Cantwell1,2, Emer Fahy3, Emily R Walters4, Joanne M Patterson5. 1. Department of Nutrition and Dietetics, Mersey Care NHS Foundation Trust, Whiston Health Centre, Liverpool, L35 3SX, UK. Cantwell505@gmail.com. 2. School of Health Sciences, University of Liverpool, Liverpool Head and Neck Centre, Liverpool, UK. Cantwell505@gmail.com. 3. Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK. 4. University of Southampton, Southampton, UK. 5. School of Health Sciences, University of Liverpool, Liverpool Head and Neck Centre, Liverpool, UK.
Abstract
PURPOSE: Prehabilitation affords an opportunity to support the management of malnutrition that is strongly associated with head and neck cancer. The purpose of this systematic review was to identify the components of nutritional prehabilitation interventions and their effects on nutritional and health outcomes in head and neck cancer patients. METHODS: A comprehensive search was completed within Medline (including PubMed), CINHAL, Cochrane database, EMBASE, PRoQUEST, clinical trials registries, and grey literature to identify studies involving a nutritional intervention pre-treatment in head and neck cancer patients receiving any form of curative therapy. Nutritional intervention was defined as a specified period pre-treatment and outcome measures had to include assessment of nutritional status or body composition. Quality of included studies was assessed using Cochrane risk of bias 2. RESULTS: From 557 identified studies, two met the inclusion criteria. Due to the low number of studies, a meta-analysis was not indicated. Both studies conducted a nutritional intervention using an "enriched formula" in malnourished patients prior to surgery. Neither study reported the intervention was effective for reducing weight loss, physical function, surgical complications, or length of stay versus the comparison. CONCLUSION: There is limited nutritional prehabilitation research within head and neck cancer. An "enriched formula" provided in the prehabilitation period appears no more advantageous than routine standard nutritional formula in mitigating against the weight loss experienced in malnourished head and neck patient. Due to the malnutrition risks on diagnosis and the negative impact of poor nutritional status on clinical and functional outcomes, robust nutritional prehabilitation research is required to inform clinical practice.
PURPOSE: Prehabilitation affords an opportunity to support the management of malnutrition that is strongly associated with head and neck cancer. The purpose of this systematic review was to identify the components of nutritional prehabilitation interventions and their effects on nutritional and health outcomes in head and neck cancer patients. METHODS: A comprehensive search was completed within Medline (including PubMed), CINHAL, Cochrane database, EMBASE, PRoQUEST, clinical trials registries, and grey literature to identify studies involving a nutritional intervention pre-treatment in head and neck cancer patients receiving any form of curative therapy. Nutritional intervention was defined as a specified period pre-treatment and outcome measures had to include assessment of nutritional status or body composition. Quality of included studies was assessed using Cochrane risk of bias 2. RESULTS: From 557 identified studies, two met the inclusion criteria. Due to the low number of studies, a meta-analysis was not indicated. Both studies conducted a nutritional intervention using an "enriched formula" in malnourished patients prior to surgery. Neither study reported the intervention was effective for reducing weight loss, physical function, surgical complications, or length of stay versus the comparison. CONCLUSION: There is limited nutritional prehabilitation research within head and neck cancer. An "enriched formula" provided in the prehabilitation period appears no more advantageous than routine standard nutritional formula in mitigating against the weight loss experienced in malnourished head and neck patient. Due to the malnutrition risks on diagnosis and the negative impact of poor nutritional status on clinical and functional outcomes, robust nutritional prehabilitation research is required to inform clinical practice.
Authors: Harriët Jager-Wittenaar; Pieter U Dijkstra; Gerard Dijkstra; Johan Bijzet; Johannes A Langendijk; Bernard F A M van der Laan; Jan L N Roodenburg Journal: Nutrition Date: 2016-12-14 Impact factor: 4.008
Authors: C Martín Villares; J Domínguez Calvo; J San Román Carbajo; M E Fernández Pello; P Pomar Blanco; M Tapia Risueño Journal: Nutr Hosp Date: 2004 Nov-Dec Impact factor: 1.057
Authors: Karmen N Schmidt; Kärin Olson; Catherine Kubrak; Matthew Parliament; Sunita Ghosh Journal: Support Care Cancer Date: 2012-05-16 Impact factor: 3.603
Authors: Jacqueline A E Langius; Myrna C Zandbergen; Simone E J Eerenstein; Maurits W van Tulder; C René Leemans; Mark H H Kramer; Peter J M Weijs Journal: Clin Nutr Date: 2013-06-26 Impact factor: 7.324