Role of intensive nutrition support and prophylactic percutaneous endoscopic gastrostomy during concomitant chemoradiotherapy for oropharyngeal cancer

Takahashi, Miki; Kosaka, Nana; Wakui, Emi; Iwaki, Shinobu; Nishii, Mika; Teshima, Masanori; Shinomiya, Hirotaka; Morimoto, Koichi; Kiyota, Naomi; Sasaki, Ryohei; Usami, Makoto; Otsuki, Naoki; Nibu, Ken‐ichi

doi:10.1007/s10147-018-1328-x

Cited by 6 publications

(4 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nutritional intervention has been reported to improve mucositis and is effective during postoperative treatment. 33 In contrast, the reduced SMI was not a risk factor for a low FOIS score, possibly due to the low prevalence of sarcopenia during hospitalization in the present study. However, prolonged dysphagia after discharge sometimes results in reduced body weight and flap atrophy and would further exacerbate dysphagia.…”

Section: Discussioncontrasting

confidence: 69%

What Factors Affect Changes in Body Composition and Swallowing Function in Patients Hospitalized for Oral Cancer Surgery?

Kagifuku

Tohara

Wakasugi

et al. 2020

CIA

View full text Add to dashboard Cite

There are few studies about sarcopenia before and after surgery for oral cancer. Therefore, we examined body composition during hospitalization and factors affecting weight loss, skeletal muscle mass index (SMI) reduction, and swallowing function at discharge in this patient group. Patients and Methods: A prospective survey was conducted at Tokyo Medical and Dental University Dental Hospital for patients who underwent primary surgery for oral cancer and reconstruction using free flaps. We compared body weight, SMI, grip strength, and walking speed at admission and discharge. We also examined factors affecting weight loss and SMI reduction and the functional oral intake scale (FOIS) score at discharge. Results: There were 26 patients that we could survey during the period. As a result of Wilcoxon's signed-rank test, body weight, SMI, and grip strength were significantly reduced during hospitalization, but no reduction was noted for sarcopenia. As a result of multiple regression analysis, postoperative chemoradiotherapy was a risk factor for weight loss, reduced SMI, and low FOIS score at discharge. Conclusion: Postoperative chemoradiotherapy is a risk factor for weight loss, muscle mass loss, and dysphagia at discharge, and chemoradiotherapy may affect rather than an invasion of surgery. After surgery, besides follow-ups for cancer, oral cancer patients should be followed up to assess dysphagia, undernutrition, and sarcopenia.

show abstract

Section: Discussioncontrasting

confidence: 69%

What Factors Affect Changes in Body Composition and Swallowing Function in Patients Hospitalized for Oral Cancer Surgery?

Kagifuku

Tohara

Wakasugi

et al. 2020

CIA

View full text Add to dashboard Cite

show abstract

“…Similar to our data, Takahasi et al showed that PEG tube placement constituted a practicable nutritional intervention with quite a few benefits, such as effective reduction of treatment-related weight loss with stable weight at the end of RT: median weight at PEG tube placement was 67.4 vs 67.3 kg at the end of RT. 34 These data underscore the importance of monitoring the nutritional status of HNC patients, indicating that timing is important as well.…”

Section: Discussionmentioning

confidence: 91%

Percutaneous Endoscopic Gastrostomy Tube Placement in Patients with Head and Neck Cancer Treated with Radiotherapy

Lang¹,

Shafie²,

Akbaba³

et al. 2020

CMAR

View full text Add to dashboard Cite

Background and aim: The primary aim of our study was to evaluate percutaneous endoscopic gastrostomy (PEG) tube placement depending on body weight and body mass index in patients undergoing radiotherapy (RT) for head and neck cancer (HNC). A secondary aim was to evaluate the course of weight change following PEG placement. Methods: We retrospectively reviewed the medical records of 186 patients with HNC undergoing radiotherapy (RT) or chemoradiotherapy (CRT) at our institution between January 2010 and August 2017. Initial weight and nutritional intake were analyzed prior to RT initiation and then followed throughout treatment until completion. Based on these data, the indication of PEG placement was determined. Medical records were also reviewed to analyze PEG-related acute toxicities. Results: A total of 186 patients met inclusion criteria. Patients were most commonly male (n=123, 66.1%) with squamous cell carcinoma (n=164, 88.2%). Patients who had dysphagia prior to treatment initiation as well as patients with a BMI <18.5 kg/m 2 needed PEG placement earlier during the treatment course. Low-grade toxicities related to PEG insertion were observed in 10.7% patients, with peristomal pain and redness adjacent to the PEG tube insertion site being most common. High-grade toxicities, such as peritonitis and organ injury, were found in 4.9% of patients. Conclusion: Underweight patients and those with preexisting dysphagia should be closely screened during RT for weight loss and decreased oral intake. For weight loss greater than 4.5% during the treatment of HNC, early PEG-tube placement should be considered. Further prospective studies are needed to confirm these findings, and delineate a scoring system for timing of PEG use (prophylactic vs reactive) as well as assess the quality of life in patients with HNC who receive PEG placement.

show abstract

“…As Diretrizes de Câncer da Sociedade Clínica da Austrália sobre Nutrição do Câncer de Cabeça e Pescoço 26 indicam que o aumento da intensidade de supervisão dietética leva à menor perda de peso, a menos interrupções no tratamento, a menores números de internações não planejadas e à melhor transição para dieta oral pós-tratamento 26 . Outro estudo realizado no Hospital Universitário de Kobe, no Japão, com pacientes com câncer de orofaringe em quimiorradioterapia, em terapia nutricional intensiva e uso de gastrostomia endoscópica percutânea, revelou aumento da ingestão de calorias, redução de efeitos adversos e dosagem completa de cisplatina, sugerindo que o suporte nutricional intensivo pode contribuir para melhores resultados em pacientes oncológicos 27 . Em estudo longitudinal, realizado em Taiwan, com pacientes oncológicos internados, resultados mostraram que pelo menos três atendimentos nutricionais aumentaram efetivamente o consumo de calorias e preservaram o peso corporal 28 .…”

Section: Discussionunclassified

Aconselhamento Nutricional em Pacientes com Câncer de Cabeça, Pescoço e Esôfago em Tratamento (Quimio)Radioterápico

Pootz

Boff²,

Canuto

et al. 2020

Rev. Brasileira.De.Cancerologia

View full text Add to dashboard Cite

Introdução: A presença de um nutricionista no setor de radioterapia objetiva a recuperação e a manutenção do estado nutricional dos pacientes. Objetivo: Comparar os resultados do aconselhamento nutricional diário com o aconselhamento nutricional semanal em pacientes com câncer de cabeça, pescoço e esôfago em tratamento radioterápico. Método: Foram selecionados 29 pacientes para o estudo e separados aleatoriamente em dois grupos. O grupo intervenção recebeu aconselhamento nutricional diariamente. O grupo padrão recebeu aconselhamento nutricional semanalmente. De ambos os grupos, foram aferidos peso corporal, circunferência braquial ou de panturrilha, avaliação subjetiva global produzida pelo próprio paciente (ASG-PPP) e calculo do recorda tório alimentar diário. Resultados: A maioria dos participantes era do sexo masculino (80%), com media de idade de 62,7 ± 26 anos. A terapia nutricional oral foi necessária para 48% dos indivíduos e, ao final do tratamento, 60% estavam em uso de nutrição enteral. A perda de peso media no grupo intervenção foi de 1,89 ± 2,58 Kg comparada a perda media de peso no grupo padrão de 9,92 ± 6,68 Kg (p=0,017). Metade dos pacientes do grupo intervenção, que iniciaram o tratamento categorizados pela ASG-PPP em A, finalizou o tratamento nessa mesma categoria (41,7%). Mais de 40% dos pacientes do grupo intervenção alcançaram as necessidades calóricas durante cinco semanas do tratamento. Conclusão: Encontraram-se resultados significativos para menor perda de peso em pacientes com aconselhamento nutricional diário que podem futuramente ser precursores de diretrizes que orientem e direcionem profissionais a condutas especificas aos pacientes com esse perfil.

show abstract

Role of intensive nutrition support and prophylactic percutaneous endoscopic gastrostomy during concomitant chemoradiotherapy for oropharyngeal cancer

Abstract: These results suggest that INS in addition to prophylactic PEG not only decreases adverse effects but also may potentially improve oncological outcome of the patients with oropharyngeal cancer treated by CCRT.

Cited by 6 publications

References 14 publications

<p>What Factors Affect Changes in Body Composition and Swallowing Function in Patients Hospitalized for Oral Cancer Surgery?</p>

<p>What Factors Affect Changes in Body Composition and Swallowing Function in Patients Hospitalized for Oral Cancer Surgery?</p>

<p>Percutaneous Endoscopic Gastrostomy Tube Placement in Patients with Head and Neck Cancer Treated with Radiotherapy</p>

Aconselhamento Nutricional em Pacientes com Câncer de Cabeça, Pescoço e Esôfago em Tratamento (Quimio)Radioterápico

Contact Info

Product

Resources

About