Top

European Archives of Oto-Rhino-Laryngology

Published in:

01-02-2017 | Head and Neck

Intensive nutritional care for patients treated with radiotherapy in head and neck cancer: a randomized study and meta-analysis

Authors: Lise-Marie Roussel, Emmanuel Micault, Damien Peyronnet, David Blanchard, Séverine Guarnieri, Olivier Choussy, Bernard Géry, Arnaud Béquignon, Corinne Joubert, Jean-Jacques Parienti, Emmanuel Babin

Published in: European Archives of Oto-Rhino-Laryngology | Issue 2/2017

Abstract

Nutritional care improves quality of life (QOL) in head and neck cancer patients treated with radiotherapy. The aim of our study was to determine whether intensive nutritional care (INC) would further improve QOL. In addition to a control group based on European and American guidelines, patients included in the INC group received six meetings with a dietitian. QOL was measured after radiotherapy using the EORTC QLQ-C30. We performed a meta-analysis to determine the best nutritional care. In the 87 patients, the QOL scores, weight, energy, and protein intakes were similar between the INC group (n = 43) and the control group (n = 44). The meta-analysis revealed no heterogeneity and significant differences in QOL (three studies) (p = 0.46) or weight changes after radiotherapy (four studies) (p = 0.06). The nutritional care specified in the European and American guidelines is composed of well-defined recommendations, and appears sufficient to maintain QOL without further intervention.

Available only for authorised users

Langius JAE, Zandbergen MC, Eerenstein SEJ et al (2013) Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo)radiotherapy: a systematic review. Clin Nutr Edinb Scotl 32:671–678. doi:10.1016/j.clnu.2013.06.012 CrossRef

Unsal D, Mentes B, Akmansu M et al (2006) Evaluation of nutritional status in cancer patients receiving radiotherapy: a prospective study. Am J Clin Oncol 29:183–188. doi:10.1097/01.coc.0000198745.94757.ee CrossRefPubMed

Ravasco P, Monteiro-Grillo I, Marques Vidal P, Camilo ME (2005) Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head Neck 27:659–668. doi:10.1002/hed.20221 CrossRefPubMed

Jager-Wittenaar H, Dijkstra PU, Vissink A et al (2011) Malnutrition and quality of life in patients treated for oral or oropharyngeal cancer. Head Neck 33:490–496. doi:10.1002/hed.21473 CrossRefPubMed

van den Berg MGA, Rütten H, Rasmussen-Conrad EL et al (2014) Nutritional status, food intake, and dysphagia in long-term survivors with head and neck cancer treated with chemoradiotherapy: a cross-sectional study. Head Neck 36:60–65. doi:10.1002/hed.23265 CrossRefPubMed

Regueiro CA, Aragón G, Millán I et al (1994) Prognostic factors for local control, regional control and survival in oropharyngeal squamous cell carcinoma. Eur J Cancer Oxf Engl 1990 30A:2060–2067

Chang P-H, Yeh K-Y, Huang J-S et al (2013) Pretreatment performance status and nutrition are associated with early mortality of locally advanced head and neck cancer patients undergoing concurrent chemoradiation. Eur Arch OtoRhinoLaryngol 270:1909–1915. doi:10.1007/s00405-012-2290-2 CrossRefPubMed

Almståhl A, Alstad T, Fagerberg-Mohlin B et al (2016) Explorative study on quality of life in relation to salivary secretion rate in patients with head and neck cancer treated with radiotherapy. Head Neck 38:782–791. doi:10.1002/hed.23964 CrossRefPubMed

Babin E, Sigston E, Hitier M et al (2008) Quality of life in head and neck cancers patients: predictive factors, functional and psychosocial outcome. Eur Arch OtoRhinoLaryngol 265:265–270. doi:10.1007/s00405-007-0561-0 CrossRefPubMed

10.

Meyer F, Fortin A, Wang CS et al (2012) Predictors of severe acute and late toxicities in patients with localized head-and-neck cancer treated with radiation therapy. Int J Radiat Oncol Biol Phys 82:1454–1462. doi:10.1016/j.ijrobp.2011.04.022 CrossRefPubMed

11.

da Silva Deboni ALS, Giordani AJ, Lopes NNF et al (2012) Long-term oral effects in patients treated with radiochemotherapy for head and neck cancer. Support Care Cancer 20:2903–2911. doi:10.1007/s00520-012-1418-7 CrossRef

12.

Hammerlid E, Wirblad B, Sandin C et al (1998) Malnutrition and food intake in relation to quality of life in head and neck cancer patients. Head Neck 20:540–548CrossRefPubMed

13.

Isenring EA, Bauer JD, Capra S (2007) Nutrition support using the American Dietetic Association medical nutrition therapy protocol for radiation oncology patients improves dietary intake compared with standard practice. J Am Diet Assoc 107:404–412. doi:10.1016/j.jada.2006.12.007 CrossRefPubMed

14.

Isenring EA, Capra S, Bauer JD (2004) Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area. Br J Cancer 91:447–452. doi:10.1038/sj.bjc.6601962 CrossRefPubMedPubMedCentral

15.

van den Berg MGA, Rasmussen-Conrad EL, Wei KH et al (2010) Comparison of the effect of individual dietary counselling and of standard nutritional care on weight loss in patients with head and neck cancer undergoing radiotherapy. Br J Nutr 104:872–877. doi:10.1017/S0007114510001315 CrossRefPubMed

16.

van der Molen L, van Rossum MA, Burkhead LM et al (2009) Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review. Eur Arch OtoRhinoLaryngol 266:889–900. doi:10.1007/s00405-008-0817-3 CrossRefPubMed

17.

Bossola M (2015) Nutritional interventions in head and neck cancer patients undergoing chemoradiotherapy: a narrative review. Nutrients 7:265–276. doi:10.3390/nu7010265 CrossRefPubMedPubMedCentral

18.

Isenring E, Capra S, Bauer J, Davies PSW (2003) The impact of nutrition support on body composition in cancer outpatients receiving radiotherapy. Acta Diabetol 40(Suppl 1):S162–S164. doi:10.1007/s00592-003-0054-6 CrossRefPubMed

19.

van den Berg MGA, Kalf JG, Hendriks JCM et al (2016) Normalcy of food intake in patients with head and neck cancer supported by combined dietary counseling and swallowing therapy: a randomized clinical trial. Head Neck 38(Suppl 1):E198–E206. doi:10.1002/hed.23970 CrossRefPubMed

20.

de Graeff A, de Leeuw JR, Ros WJ et al (2000) Long-term quality of life of patients with head and neck cancer. Laryngoscope 110:98–106. doi:10.1097/00005537-200001000-00018 CrossRefPubMed

21.

Slevin ML (1992) Quality of life: philosophical question or clinical reality? BMJ 305:466–469CrossRefPubMedPubMedCentral

22.

Breitbart W, Holland J (1988) Psychosocial aspects of head and neck cancer. Semin Oncol 15:61–69PubMed

23.

Babin E, Heutte N, Grandazzi G et al (2014) Quality of life and supportive care in head and neck cancers. Bull Cancer (Paris) 101:505–510. doi:10.1684/bdc.2014.1960

24.

Elliot L, Molseed L, McCallum P, Grant B (2006) The clinical guide to oncology nutrition. 2nd edn, American Dietetic Association, Chicago, IL

25.

Sobin LH, Gospodarowicz MK, Wittekind C (2011) TNM classification of malignant tumours. Wiley, Oxford

26.

Arends J, Bodoky G, Bozzetti F et al (2006) ESPEN guidelines on enteral nutrition: non-surgical oncology. Clin Nutr Edinb Scotl 25:245–259. doi:10.1016/j.clnu.2006.01.020 CrossRef

27.

Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376CrossRefPubMed

28.

Bjordal K, de Graeff A, Fayers PM et al (2000) A 12 country field study of the EORTC QLQ-C30 (version 3.0) and the head and neck cancer specific module (EORTC QLQ-H&N35) in head and neck patients. EORTC Quality of Life Group. Eur J Cancer Oxf Engl 1990 36:1796–1807

29.

http://www.euroqol.org

30.

Jellema AP, Slotman BJ, Doornaert P et al (2007) Impact of radiation-induced xerostomia on quality of life after primary radiotherapy among patients with head and neck cancer. Int J Radiat Oncol Biol Phys 69:751–760. doi:10.1016/j.ijrobp.2007.04.021 CrossRefPubMed

31.

Vissink A, Jansma J, Spijkervet FKL et al (2003) Oral sequelae of head and neck radiotherapy. Crit Rev Oral Biol Med 14:199–212CrossRefPubMed

32.

Burlage FR, Coppes RP, Meertens H et al (2001) Parotid and submandibular/sublingual salivary flow during high dose radiotherapy. Radiother Oncol J Eur Soc Ther Radiol Oncol 61:271–274CrossRef

33.

Gillbreath J, Inman-Felton A, Johnson E et al (1998) Medical nutrition therapy across the continuum of care–client protocols. American Dietetic Association, Chicago

34.

Mekhail TM, Adelstein DJ, Rybicki LA et al (2001) Enteral nutrition during the treatment of head and neck carcinoma: is a percutaneous endoscopic gastrostomy tube preferable to a nasogastric tube? Cancer 91:1785–1790CrossRefPubMed

Title: Intensive nutritional care for patients treated with radiotherapy in head and neck cancer: a randomized study and meta-analysis
Authors: Lise-Marie Roussel
Emmanuel Micault
Damien Peyronnet
David Blanchard
Séverine Guarnieri
Olivier Choussy
Bernard Géry
Arnaud Béquignon
Corinne Joubert
Jean-Jacques Parienti
Emmanuel Babin
Publication date: 01-02-2017
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 2/2017
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-016-4278-9

At a glance: The STEP trials

Springer Medicine

Intensive nutritional care for patients treated with radiotherapy in head and neck cancer: a randomized study and meta-analysis

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2017

Genetics of ion homeostasis in Ménière’s Disease

Using preoperative unsupervised cluster analysis of chronic rhinosinusitis to inform patient decision and endoscopic sinus surgery outcome

Variation in treatment and outcome in the early stage oral cavity squamous cell carcinoma

Comparing two lower-dose cisplatin programs for radio-chemotherapy of locally advanced head-and-neck cancers

Clinical features and surgical treatment for Chinese juvenile onset current respiratory papillomatosis (JORRP)

Additional non-sentinel lymph node metastases in early oral cancer patients with positive sentinel lymph nodes