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Nutrients 2015, 7(1), 265-276; doi:10.3390/nu7010265

Nutritional Interventions in Head and Neck Cancer Patients Undergoing Chemoradiotherapy: A Narrative Review

Department of Surgery, Catholic University, University Hospital "A. Gemelli", Largo A. Gemelli, 8-00168 Rome, Italy
Received: 10 November 2014 / Accepted: 24 December 2014 / Published: 5 January 2015
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)
View Full-Text   |   Download PDF [148 KB, uploaded 5 January 2015]

Abstract

The present review aimed to define the role of nutritional interventions in the prevention and treatment of malnutrition in HNC patients undergoing CRT as well as their impact on CRT-related toxicity and survival. Head and neck cancer patients are frequently malnourished at the time of diagnosis and prior to the beginning of treatment. In addition, chemo-radiotherapy (CRT) causes or exacerbates symptoms, such as alteration or loss of taste, mucositis, xerostomia, fatigue, nausea and vomiting, with consequent worsening of malnutrition. Nutritional counseling (NC) and oral nutritional supplements (ONS) should be used to increase dietary intake and to prevent therapy-associated weight loss and interruption of radiation therapy. If obstructing cancer and/or mucositis interfere with swallowing, enteral nutrition should be delivered by tube. However, it seems that there is not sufficient evidence to determine the optimal method of enteral feeding. Prophylactic feeding through nasogastric tube or percutaneous gastrostomy to prevent weight loss, reduce dehydration and hospitalizations, and avoid treatment breaks has become relatively common. Compared to reactive feeding (patients are supported with oral nutritional supplements and when it is impossible to maintain nutritional requirements enteral feeding via a NGT or PEG is started), prophylactic feeding does not offer advantages in terms of nutritional outcomes, interruptions of radiotherapy and survival. Overall, it seems that further adequate prospective, randomized studies are needed to define the better nutritional intervention in head and neck cancer patients undergoing chemoradiotherapy. View Full-Text
Keywords: head and neck cancer; chemoradiotherapy; malnutrition; nutrition; nutritional counseling; oral nutritional supplements; enteral nutrition; gastrostomy head and neck cancer; chemoradiotherapy; malnutrition; nutrition; nutritional counseling; oral nutritional supplements; enteral nutrition; gastrostomy
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Bossola, M. Nutritional Interventions in Head and Neck Cancer Patients Undergoing Chemoradiotherapy: A Narrative Review. Nutrients 2015, 7, 265-276.

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