Nutritional Counseling for Head and Neck Cancer Patients Undergoing (Chemo) Radiotherapy—A Prospective Randomized Trial

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http://hdl.handle.net/10138/308440

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Orell , H , Schwab , U , Saarilahti , K , Österlund , P , Ravasco , P & Mäkitie , A 2019 , ' Nutritional Counseling for Head and Neck Cancer Patients Undergoing (Chemo) Radiotherapy—A Prospective Randomized Trial ' , Frontiers in nutrition , vol. 6 , 22 . https://doi.org/10.3389/fnut.2019.00022

Title: Nutritional Counseling for Head and Neck Cancer Patients Undergoing (Chemo) Radiotherapy—A Prospective Randomized Trial
Author: Orell, Helena; Schwab, Ursula; Saarilahti, Kauko; Österlund, Pia; Ravasco, Paula; Mäkitie, Antti
Contributor: University of Helsinki, Clinicum
University of Helsinki, HUS Comprehensive Cancer Center
University of Helsinki, HUS Comprehensive Cancer Center
University of Helsinki, HUS Head and Neck Center
Date: 2019-03-18
Language: eng
Number of pages: 12
Belongs to series: Frontiers in nutrition
ISSN: 2296-861X
URI: http://hdl.handle.net/10138/308440
Abstract: Background: Head and neck cancer and its treatment may deteriorate nutrition status. Previous data have shown that intensive nutrition intervention by a dietician reduces radiation-induced adverse events including weight loss. Objective: To determine if on-demand nutrition counselling (ODC) would be as effective as intensive nutrition counselling (INC) in patients undergoing (chemo)radiotherapy. Methods: Fifty-eight patients were randomly assigned to receive INC (n=26) or ODC (n=32). Outcome measures were nutrition status (PG-SGA), weight loss, handgrip strength (HGS), body composition and survival. Results: Weight loss and impaired nutrition parameters during oncological treatment were seen equally in both groups (NS). Leaner patients at baseline maintained their weight, while overweight patients lost both weight and handgrip strength during treatment. Disease- free survival (DFS) (median=43 months) was not affected by weight loss during treatment. Lower baseline HGS and malnutrition were associated with worse DFS (low vs. normal HGS: 15 vs. 42 months; p=0.05 and malnutrition vs. good nutrition status: 17 vs. 42 months; p=0.014, respectively). Survival according to low vs. normal HGS in the INC group was 4 vs. 44 months (p=0.007) and in the ODC group 28 vs. 40 months (p=0.944). According to malnutrition vs. good nutrition status in the INC group, DFS was 21 vs. 43 months (p=0.025) and in the ODC group 15 vs. 41 months (p=0.03). Conclusions: Individualised on-demand nutrition counselling was as efficient as intensive counselling during (chemo)radiotherapy. Overweight patients had more severe weight loss but not poorer survival. Low HGS and malnutrition at baseline were directly associated with poor survival.
Subject: 3122 Cancers
3143 Nutrition
nutritional status
handgrip strength
nutritional intervention
survival
weight loss
CRITICAL WEIGHT-LOSS
CLINICAL-IMPLICATIONS
DIETARY-INTAKE
GRIP STRENGTH
RISK-FACTORS
INTERVENTION
MALNUTRITION
PREVALENCE
SURVIVAL
THERAPY
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