Postoperative enteral immunonutrition in head and neck cancer patients: Impact on clinical outcomes

Poor treatment tolerance in head and neck cancer patients with low muscle mass

“…Specifically, patients with operable head and neck cancer given enteral immunonutrition 5 days prior to surgery were found to have significantly less postoperative wound complications and length of stay compared to those undergoing standard nutrition 26 . Similarly, Barajas‐Galindo et al showed that the utilization of postoperative immunonutrition appeared to reduce fistula rate and length of stay 27 . Compared to other studies, BMI, measured both as a categorical and continuous variable, did not appear to resolve as a predictor factor for treatment tolerance or delays to adjuvant therapy.…”

“…Perioperative immunonutrition which enhances basic nutrients with arginine and glutamine, ribonucleic acid, and omega‐3 fatty acids have shown possible reduced postoperative infections and length of stay in operable HNSCC 25 . Despite this, no clear regimen exists on the timing and duration of perioperative immunonutrition 25–28 . Specifically, patients with operable head and neck cancer given enteral immunonutrition 5 days prior to surgery were found to have significantly less postoperative wound complications and length of stay compared to those undergoing standard nutrition 26 .…”

Dietary Supplements in People with Metastatic Cancer Who Are Experiencing Malnutrition, Cachexia, Sarcopenia, and Frailty: A Scoping Review

“…The 48 articles were classified into the following categories: full text peer-reviewed manuscripts (n = 38), conference abstracts (n = 8), and clinical trial registrations (n = 2). Of the full text peer-reviewed manuscripts, the majority reported on randomized controlled trials (RCTs) (n = 18) [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51], followed by quasi-experimental trials (n = 15) [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66], retrospective cohort observational studies (n = 2) [67,68], and case studies (n = 3) [69][70][71]. Conference abstracts reported on RCTs (n = 3) [72][73][74], quasi-experimental trials (n = 4) [75][76][77][78], and a case study (n = 1) [79].…”

“…A variety of dietary supplements were investigated across studies and were grouped into the following categories: vitamins (n = 13), minerals (n = 5), antioxidants (apart from vitamins and minerals) (n = 7), proteins (n = 3), amino acids (n = 14), fatty acids (n = 18), fiber (n = 1), and others (n = 5). Dietary supplements were provided orally in all except three studies [36,67,71], where they were administered enterally. Table 3 shows the types of dietary supplements, cancers, and malnutrition-related conditions in each of the different studies.…”

“…Arginine was the second most commonly investigated amino acid. Arginine was the main dietary supplement investigated in an RCT where it was administered in the form of a specially formulated enteral formula and replaced 41% of casein [36], as well as in an observational study where it was given in the form of an immunonutrition enteral formula (Impact ® ) containing 12.5 g/L L-arginine, dietary nucleotides, EPA, and docosahexaenoic acid (DHA) [67]. Arginine was investigated as part of a combined treatment with glutamine (amino acid) and β-hydroxyl β-methyl butyrate (HMB) (amino acid metabolite) in three studies (two RCTs [35,45] and one quasi-experimental trial [57]), which were also the only studies where glutamine or HMB were included.…”