Enteral nutrition support and treatment toxicities in patients with head and neck cancer receiving definitive or adjuvant helical intensity‐modulated radiotherapy with concurrent chemotherapy

Abstract

Background Enteral nutrition (EN) is often required in patients with head and neck cancer (HNSCC); however, initiation criteria is limited or inconsistent. This study aimed to describe the relationship of treatment toxicities and requirement for EN and investigate toxicity and baseline characteristics association with EN duration. Methods Acute toxicities and baseline characteristics were collected from patients with HNSCC (n = 110) undergoing H‐IMRT. Percentage EN contributing to estimated requirements and EN duration were measured. Results The threshold for patients needing ≥50% of estimated requirements via EN increased from week 3 to 4 for grade ≥2 oral/pharyngeal mucositis, dysgeusia, thick saliva and nausea, and for grade 3 dysphagia. Patients with grade 2–3 dysphagia had a reduced risk of ceasing EN compared to those with grade 0–1 dysphagia. Conclusions Using acute toxicities in clinical practice may be a useful tool to inform prompt initiation of EN prior to decline in nutritional status and anticipate EN duration.

Nutrition in HNSCC: is it a matter for oncologists? The role of multidisciplinary team—a narrative literature review

“…Swallowing dysfunction is common in patients who present with HNSCC, and failure to recognize this condition can lead to worsening malnutrition or aspiration pneumonia ( 25 – 28 ).…”

Nutrition outcomes and treatment toxicities in patients with head and neck cancer receiving helical intensity‐modulated radiotherapy

“…The results of the present study suggest that current local practice interventions of prophylaxis antiemetic protocols for high emetogenic risk chemotherapy protocols and nutrition interventions, including weekly dietary counselling and enteral nutrition support, is not adequate to effectively manage nausea and prevent subsequent weight loss. Research into patient adherence to antiemetic protocols and additional interventions such as continual prophylactic antiemetic and/or prokinetic protocols throughout the treatment period, the use of practical clinical measures to guide timely initiation of enteral nutrition support, 34 proactive humidification for secretion management, and routine psychological screening for early identification and intervention is required.…”