Nutritional support for head and neck cancer patients receiving radiotherapy: a systematic review

Garg, Shashank; Yoo, John; Winquist, Eric

doi:10.1007/s00520-009-0686-3

Cited by 104 publications

(100 citation statements)

References 17 publications

(49 reference statements)

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“…S. Garg и соавт. [9] на основании изучения 10 рандомизированных клинических исследований приш-ли к выводу, что восстановление энтерального питания в комплексе с консультированием диетологом улучшает нутритивный статус у данной группы пациентов.…”

Section: Discussionunclassified

Radiology-guided percutaneous gastrostomy in patients with malignant dysphagia

Tsepenshchikov¹,

Absalyamov²,

Neklyudova³

et al. 2015

Onkol. Z. im. P.A. Gercena

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Проведена оценка результатов применения перкутанной рентгенассистированной гастростомии у 26 больных с опухо-левой дисфагией различной локализации. Освещены вопросы коррекции нутритивной недостаточности у этих больных. Рассмотрены преимущества и недостатки различных методов восстановления энтерального питания. Ключевые слова: гастростома, дисфагия, нутритивная недостаточность.The results of radiology-guided percutaneous gastrostomy were assessed in 26 patients with malignant dysphagia at different sites. The paper highlights the issues of correction of nutritional deficiency in these patients. It considers the advantages and disadvantages of different methods for recovery of enteral nutrition.

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Section: Discussionunclassified

Radiology-guided percutaneous gastrostomy in patients with malignant dysphagia

Tsepenshchikov¹,

Absalyamov²,

Neklyudova³

et al. 2015

Onkol. Z. im. P.A. Gercena

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“…There is level I evidence for the role of nutrition support for patients receiving radiotherapy from two positive quality systematic reviews (Garg, Yoo, & Winquist, 2010;Langius et al, 2013c). Garg et al (2010) identified three RCT's in relation to dietary counselling (Isenring, Bauer, & Capra, 2007;Isenring, Capra, & Bauer, 2004;Ravasco et al, 2005a) and two RCT's in relation to oral nutrition supplements (Arnold & Richter, 1989;Nayel, el-Ghoneimy, & el-Haddad, 1992).…”

Section: Dietary Counseling and Oral Nutrition Supplementsmentioning

confidence: 99%

“…Garg et al (2010) identified three RCT's in relation to dietary counselling (Isenring, Bauer, & Capra, 2007;Isenring, Capra, & Bauer, 2004;Ravasco et al, 2005a) and two RCT's in relation to oral nutrition supplements (Arnold & Richter, 1989;Nayel, el-Ghoneimy, & el-Haddad, 1992). The systematic review by Langius et al (2013c) identified two additional RCT's for dietary counselling (Macia et al, 1991;van den Berg et al, 2010) and they also included Ravasco et al (2005a) in the analysis of oral nutrition supplements as this study had a third arm of oral supplements alone for comparison.…”

Section: Dietary Counseling and Oral Nutrition Supplementsmentioning

confidence: 99%

“…The role of dietary counselling in improving nutrition outcomes for patients with head and neck cancer has been well documented (Garg et al, 2010;Langius et al, 2013c), but the optimal management with patients requiring enteral tube feeding remains unclear and so no firm recommendations can be made (Langius et al, 2013c;Nugent et al, 2013). The debate in the literature continues as to whether patients with head and neck cancer should have a nasogastric tube or gastrostomy tube (Corry et al, 2008;Wang et al, 2014a) and the optimal timing of gastrostomy placement (Bradley, Brown, & Paleri, 2015;Talwar & Findlay, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…Evidencebased guidelines are available to provide optimal nutrition care to this patient group throughout the treatment trajectory (Brown et al, 2013a). There is good evidence to support the role of dietetic counselling to improve nutrition outcomes in patients with head and neck cancer receiving radiotherapy (Garg et al, 2010). Enteral tube feeding via a gastrostomy or nasogastric tube is often required in response to dysphagia, odynophagia or other side effects of treatment that lead to dehydration and/or weight-loss during or after cancer treatment.…”

Section: Introductionmentioning

confidence: 99%

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Optimising nutrition support in patients with head and neck cancer

Brown¹

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Association of Body Composition With Survival and Locoregional Control of Radiotherapy-Treated Head and Neck Squamous Cell Carcinoma

et al. 2016

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IMPORTANCE Major weight loss is common in patients with head and neck squamous cell carcinoma (HNSCC) who undergo radiotherapy (RT). How baseline and posttreatment body composition affects outcome is unknown. OBJECTIVE To determine whether lean body mass before and after RT for HNSCC predicts survival and locoregional control. DESIGN, SETTING, AND PARTICIPANT Retrospective study of 2840 patients with pathologically proven HNSCC undergoing curative RT at a single academic cancer referral center from October 1, 2003, to August 31, 2013. One hundred ninety patients had computed tomographic (CT) scans available for analysis of skeletal muscle (SM). The effect of pre-RT and post-RT SM depletion (defined as a CT-measured L3 SM index of less than 52.4 cm2 /m2 for men and less than 38.5 cm2 /m2 for women) on survival and disease control was evaluated. Final follow-up was completed on September 27, 2014, and data were analyzed from October 1, 2014, to November 29, 2015. MAIN OUTCOMES AND MEASURES Primary outcomes were overall and disease-specific survival and locoregional control. Secondary analyses included the influence of pre-RT body mass index (BMI) and interscan weight loss on survival and recurrence. RESULTS Among the 2840 consecutive patients who underwent screening, 190 had whole-body positron emission tomography–CT or abdominal CT scans before and after RT and were included for analysis. Of these, 160 (84.2%) were men and 30 (15.8%) were women; their mean (SD) age was 57.7 (9.4) years. Median follow up was 68.6 months. Skeletal muscle depletion was detected in 67 patients (35.3%) before RT and an additional 58 patients (30.5%) after RT. Decreased overall survival was predicted by SM depletion before RT (hazard ratio [HR], 1.92; 95% CI, 1.19–3.11; P = .007) and after RT (HR, 2.03; 95% CI, 1.02–4.24; P = .04). Increased BMI was associated with significantly improved survival (HR per 1-U increase in BMI, 0.91; 95% CI, 0.87–0.96; P < .001). Weight loss without SM depletion did not affect outcomes. Post-RT SM depletion was more substantive in competing multivariate models of mortality risk than weight loss–based metrics (Bayesian information criteria difference, 7.9), but pre-RT BMI demonstrated the greatest prognostic value. CONCLUSIONS AND RELEVANCE Diminished SM mass assessed by CT imaging or BMI can predict oncologic outcomes for patients with HNSCC, whereas weight loss after RT initiation does not predict SM loss or survival.

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Nutritional support for head and neck cancer patients receiving radiotherapy: a systematic review

Cited by 104 publications

References 17 publications

Radiology-guided percutaneous gastrostomy in patients with malignant dysphagia

Radiology-guided percutaneous gastrostomy in patients with malignant dysphagia

Optimising nutrition support in patients with head and neck cancer

Association of Body Composition With Survival and Locoregional Control of Radiotherapy-Treated Head and Neck Squamous Cell Carcinoma

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