Nutrition Impact Symptom Clusters in Patients With Head and Neck Cancer Receiving Concurrent Chemoradiotherapy

Wang, Yujie; Lü, Qian; Zhang, Lichuan; Zhuang, Bing; Zhang, Tong; Jin, Sanli; Sun, Yan; Xiao, Shan; Zheng, Bingna; Fang, Yu; Gong, Liqing; Wang, Yanli; Cao, Yiwei; Wang, Weihu

doi:10.1016/j.jpainsymman.2020.12.013

Cited by 20 publications

(28 citation statements)

References 35 publications

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“…It was clear that the patients had negative changes in OM-related eating. During the radiotherapy, increases in weight loss and NRS scores were observed as each week passed [32,34,35]. It has been reported in the literature that patients experience anxiety, fear, or sadness about how they can participate in the eating experience.…”

Section: Discussionmentioning

confidence: 99%

“…Weight loss is an important prognostic factor [11]. Many patients undergoing radiation therapy face a high risk of weight loss due to tumor metabolism and the toxicities of the therapy [3,32]. Studies have shown that more severe diet-related comorbidities are associated with greater weight loss [3,31,32].…”

Section: Discussionmentioning

confidence: 99%

“…Many patients undergoing radiation therapy face a high risk of weight loss due to tumor metabolism and the toxicities of the therapy [3,32]. Studies have shown that more severe diet-related comorbidities are associated with greater weight loss [3,31,32]. Symptoms of OM, nutrition, and weight loss are closely related and occur simultaneously, and patient-speci c evaluation and management should be a priority, rather than focusing on a single symptom [3,11,22].…”

Section: Discussionmentioning

confidence: 99%

“…Potential adverse effects of OM, OM comorbidities (such as taste change, dry mouth), weight loss, and nutritional change on adherence to treatment, quality of life, and clinical outcomes have been shown in the literatüre [29,31,32,35]. It is important to understand the patient's internal relationships and to ensure timely and appropriate management [29].…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Nurse-led Oral Mucositis Management: Impact on Health Outcomes of Patients Receiving Radiotherapy for Head and Neck Cancer and Lung Cancer: A Prospective Study

Kara

Arıkan

Kartoz

et al. 2022

Preprint

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Purpose The study aimed to evaluate the impact of nurse-led OM management on the health outcomes of patients receiving radiotherapy for head and neck cancer and lung cancer.Methods The radiotherapy nurse carried out evidence-based assessments for OM in patients diagnosed with head and neck cancer and lung cancer and scheduled to receive radiotherapy, during their visits to the radiotherapy unit. The study adopted a holistic approach involving the patient in the care process with the radiotherapy nurse screening OM complications, providing information on OM-related factors and integrating these factors into daily life. The prospective, longitudinal cohort study, 27 patients were assessed and monitored through the WHO Oral Toxicity Scale, OM Follow-up Form and educated on OM during their radiotherapy through the OM Prevention and Care Guide. At the end of radiotherapy, an Evaluation of the Radiotherapy Process was performed.Results In this study, each patient was followed for six weeks from the start of radiotherapy (n=27). During RT, 23 patients had different grades of OM and 26 patients had esophagitis.The worst clinical data for OM and its variables emerged at week 6 of treatment. While the Nutrition Risk Screening (NRS) score increased over time, weight loss was observed to decrease. The mean stress level was 4.74±0.33 in the first week and 5.77±0.35 in the last week. It was observed that 24 out of 27 patients (88.9%) showed good adherence to the treatment.Conclusion Involving the patient in the process of radiotherapy in nurse-led OM management contributes to better patient outcomes. Such an approach improves oral care management in patients receiving radiotherapy for head and neck and lung cancer, demonstrating its positive impact on additional patient-focused outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Nurse-led Oral Mucositis Management: Impact on Health Outcomes of Patients Receiving Radiotherapy for Head and Neck Cancer and Lung Cancer: A Prospective Study

Kara

Arıkan

Kartoz

et al. 2022

Preprint

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“…Previous and resent research using the HNSC © has described the relation between NIS burden and weight loss, with NIS burden before treatment being a predictor for weight loss, nutritional intake, and survival [22]. Increasing NIS burden during the treatment period is reported to negatively affect body weight [13,[23][24][25] and increase the need for oral nutritional supplements [24]. To our knowledge, is the only study reporting NIS-weight loss pattern up to 2.5 months after treatment using the HNSC © [13].…”

Section: Introductionmentioning

confidence: 99%

Granström

Holmlund

Laurell

et al. 2022

Support Care Cancer

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Purpose The purpose of this prospective study was to assess which nutritional impact symptoms (NIS) interfere with oral intake in patients with head and neck cancer (HNC) and how the symptoms interfere with body weight loss, up to 1 year after treatment. Methods This was a prospective study of 197 patients with HNC planned for treatment with curative intention. Body weight was measured before the start of treatment, at 7 weeks after the start of treatment, and at 6 and 12 months after completion of treatment. NIS and NIS interfering with oral intake at each follow-up were examined with the Head and Neck Patient Symptom Checklist© (HNSC©). Results At 7 weeks of follow-up, patients experienced the greatest symptom and interference burden, and 12 months after treatment the NIS scorings had not returned to baseline. One year after treatment, the highest scored NIS to interfere with oral intake was swallowing problems, chewing difficulties, and loss of appetite. At all 3 follow-ups, the total cumulative NIS and NIS interfering with oral intake were associated with body weight loss. Factors increasing the risk for a body weight loss of ≥ 10% at 12 months after treatment were pain, loss of appetite, feeling full, sore mouth, difficulty swallowing, taste changes, and dry mouth. Women scored higher than men in NIS and NIS interfering with oral intake. Furthermore, during the study period about half of the population had a body weight loss > 5%. Conclusion Because both nutritional and clinical factors may affect body weight, this study highlights the importance of a holistic approach when addressing the patients’ nutritional issues. Trial registration ClinicalTrials.gov NCT03343236, date of registration: November 17, 2017.

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Effect of nutrition impact symptoms on oral nutritional supplements energy intake and use days in patients with head and neck cancer: A cross‐sectional study

Dai,

Xian,

et al. 2024

Cancer Medicine

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BackgroundThis study aims to explore the effect of nutritional impact symptoms (NIS) on oral nutritional supplements (ONS) energy intake and use days among head and neck cancer (HNC) patients.MethodsA cross‐sectional study was conducted among HNC patients in a hospital in western China between January 2019 and June 2020. The NIS was from the Patient‐Generated Subjective Global Assessment (PG‐SGA) scale. Mann–Whitney test was used to examine the differences between different kinds of NIS and ONS use days. Binary logistic regression was used to determine the effect of NIS on ONS energy intake.ResultsThe most prevalent four NIS were no appetite (35.3%), dysphagia (29.4%), vomiting (13.2%) and oral pain (12.5%), respectively. All patients in the study were malnutrition. Patients with xerostomia or oral pain had less ONS use days than those without these symptoms. Patients with vomiting (OR 0.09, 95% CI 0.02–0.50) or pain (OR 0.15, 95% CI 0.02–0.89) were less likely to have ONS energy intake ≥400 kcal/day than those without these symptoms after adjusting the confounding factors. In addition, one‐point increase in total NIS score was associated with a lower proportion of ONS energy intake ≥400 kcal/day (OR 0.77, 95% CI 0.59–0.99).ConclusionXerostomia, oral pain, vomiting and pain should be strengthened and intervened to improve ONS use and nutritional status among HNC patients with malnutrition.

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Nutrition Impact Symptom Clusters in Patients With Head and Neck Cancer Receiving Concurrent Chemoradiotherapy

Cited by 20 publications

References 35 publications

Nurse-led Oral Mucositis Management: Impact on Health Outcomes of Patients Receiving Radiotherapy for Head and Neck Cancer and Lung Cancer: A Prospective Study

Nurse-led Oral Mucositis Management: Impact on Health Outcomes of Patients Receiving Radiotherapy for Head and Neck Cancer and Lung Cancer: A Prospective Study

Addressing symptoms that affect patients’ eating according to the Head and Neck Patient Symptom Checklist©

Effect of nutrition impact symptoms on oral nutritional supplements energy intake and use days in patients with head and neck cancer: A cross‐sectional study

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