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Erschienen in: Supportive Care in Cancer 6/2010

01.06.2010 | Original Article

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

verfasst von: Shashank Garg, John Yoo, Eric Winquist

Erschienen in: Supportive Care in Cancer | Ausgabe 6/2010

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Abstract

Purpose

Squamous cell carcinoma of the head and neck (HNSCC) is associated with weight loss before, during, and after treatment with radiotherapy (RT). This systematic review addressed the question “Which interventions aimed at optimizing nutrition are of benefit to HNSCC patients receiving RT?”

Methods

Randomized controlled trials (RCTs) studying interventions directed at nutritional support of adult patients with HNSCC receiving RT with or without chemotherapy were eligible. RCTs studying prophylaxis of acute mucositis, perioperative nutrition, or palliative and non-HNSCC populations were excluded. A comprehensive literature search was done and meta-analyses planned.

Results

Ten unique RCTs were identified (n = 585). All randomized less than 50 patients per trial arm. Five trials studied dietary counseling and/or nutritional supplements, four studied drug interventions, and one studied prophylactic enteral tube feeding. Nutritional status appeared to be maintained or improved with dietary counseling, megestrol acetate, and prophylactic enteral tube feeding.

Conclusions

Data from RCTs supporting the use of interventions to optimize nutrition in HNSCC patients receiving RT are limited in both quantity and quality. Potentially effective interventions have not been tested comparatively or in combination, and few patients receiving chemoradiotherapy were studied. Further research in this area is a priority.
Literatur
1.
Zurück zum Zitat Chin D, Boyle GM, Porceddu S, Theile DR, Parsons PG, Coman WB (2006) Head and neck cancer: past, present and future. Expert Rev Anticancer Ther 6(7):1111–1118CrossRefPubMed Chin D, Boyle GM, Porceddu S, Theile DR, Parsons PG, Coman WB (2006) Head and neck cancer: past, present and future. Expert Rev Anticancer Ther 6(7):1111–1118CrossRefPubMed
2.
Zurück zum Zitat Lees J (1999) Incidence of weight loss in head and neck cancer patients on commencing radiotherapy treatment at a regional oncology centre. Eur J Cancer Care 8:133–136CrossRef Lees J (1999) Incidence of weight loss in head and neck cancer patients on commencing radiotherapy treatment at a regional oncology centre. Eur J Cancer Care 8:133–136CrossRef
3.
Zurück zum Zitat Winquist E, Oliver T, Gilbert R (2007) Postoperative chemoradiotherapy for advanced squamous cell carcinoma of the head and neck: a systematic review with meta-analysis. Head Neck 29(1):38–46CrossRefPubMed Winquist E, Oliver T, Gilbert R (2007) Postoperative chemoradiotherapy for advanced squamous cell carcinoma of the head and neck: a systematic review with meta-analysis. Head Neck 29(1):38–46CrossRefPubMed
4.
Zurück zum Zitat El-Sayed S, Nabid A, Shelley W, Hay J, Balogh J, Gelinas M et al (2002) Prophylaxis of radiation-associated mucositis in conventionally treated patients with head and neck cancer: a double-blind, phase III, randomized, controlled trial evaluating the clinical efficacy of an antimicrobial lozenge using a validated mucositis scoring system. J Clin Oncol 20:3956–3963CrossRefPubMed El-Sayed S, Nabid A, Shelley W, Hay J, Balogh J, Gelinas M et al (2002) Prophylaxis of radiation-associated mucositis in conventionally treated patients with head and neck cancer: a double-blind, phase III, randomized, controlled trial evaluating the clinical efficacy of an antimicrobial lozenge using a validated mucositis scoring system. J Clin Oncol 20:3956–3963CrossRefPubMed
5.
Zurück zum Zitat Nitenberg G, Raynard B (2000) Nutritional support of the cancer patient: issues and dilemmas. Crit Rev Oncol Hematol 34:137–168CrossRefPubMed Nitenberg G, Raynard B (2000) Nutritional support of the cancer patient: issues and dilemmas. Crit Rev Oncol Hematol 34:137–168CrossRefPubMed
6.
Zurück zum Zitat Stokman MA, Spijkervet FK, Boezen HM, Schouten JP, Roodenburg JL, de Vries EG (2006) Preventive intervention possibilities in radiotherapy- and chemotherapy-induced oral mucositis: results of meta-analyses. J Dent Res 85(8):690–700CrossRefPubMed Stokman MA, Spijkervet FK, Boezen HM, Schouten JP, Roodenburg JL, de Vries EG (2006) Preventive intervention possibilities in radiotherapy- and chemotherapy-induced oral mucositis: results of meta-analyses. J Dent Res 85(8):690–700CrossRefPubMed
8.
Zurück zum Zitat Arnold C, Richter MP (1989) The effect of oral nutritional supplements on head and neck cancer. Int J Radiat Oncol Biol Phys 16:1595–1599PubMed Arnold C, Richter MP (1989) The effect of oral nutritional supplements on head and neck cancer. Int J Radiat Oncol Biol Phys 16:1595–1599PubMed
9.
Zurück zum Zitat Nayel H, El-Ghoneimy E, El-Haddad S (1992) Impact of nutritional supplementation on treatment delay and morbidity in patients with head and neck tumors treated with irradiation. Nutrition 8:13–18PubMed Nayel H, El-Ghoneimy E, El-Haddad S (1992) Impact of nutritional supplementation on treatment delay and morbidity in patients with head and neck tumors treated with irradiation. Nutrition 8:13–18PubMed
10.
Zurück zum Zitat Lovik A, Almendingen K, Dotterud M, Forli L, Boysen M, Omarhus M et al (1996) Dietary information after radiotherapy of head and neck cancer. Tidsskr Nor Laegeforen 116(19):2303–2306 NorwegianPubMed Lovik A, Almendingen K, Dotterud M, Forli L, Boysen M, Omarhus M et al (1996) Dietary information after radiotherapy of head and neck cancer. Tidsskr Nor Laegeforen 116(19):2303–2306 NorwegianPubMed
11.
Zurück zum Zitat Isenring EA, Capra S, Bauer JD (2001) Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area. Br J Cancer 91:447–452CrossRef Isenring EA, Capra S, Bauer JD (2001) Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area. Br J Cancer 91:447–452CrossRef
12.
Zurück zum Zitat Ravasco P, Monteiro-Grillo I, Vidal PM, Camilo ME (2005) Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head Neck 27(8):659–668CrossRefPubMed Ravasco P, Monteiro-Grillo I, Vidal PM, Camilo ME (2005) Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head Neck 27(8):659–668CrossRefPubMed
13.
Zurück zum Zitat Fietkau R, Riepl M, Kettner H, Hinke A, Sauer R (1997) Supportive use of megestrol acetate in patients with head and neck cancer during radio(chemo)therapy. Eur J Cancer 33:75–79CrossRefPubMed Fietkau R, Riepl M, Kettner H, Hinke A, Sauer R (1997) Supportive use of megestrol acetate in patients with head and neck cancer during radio(chemo)therapy. Eur J Cancer 33:75–79CrossRefPubMed
14.
Zurück zum Zitat Chen HC, Leung SW, Wang CJ, Sun LM, Fang FM, Hsu JH (1997) Effect of megestrol acetate and prepulsid on nutritional improvement in patients with head and neck cancers undergoing radiotherapy. Radiother Oncol 43:75–79CrossRefPubMed Chen HC, Leung SW, Wang CJ, Sun LM, Fang FM, Hsu JH (1997) Effect of megestrol acetate and prepulsid on nutritional improvement in patients with head and neck cancers undergoing radiotherapy. Radiother Oncol 43:75–79CrossRefPubMed
15.
Zurück zum Zitat McQuellon RP, Moose DB, Russell GB, Case LD, Greven K, Stevens M et al (2002) Supportive use of megestrol acetate (Megace) with head/neck and lung cancer patients receiving radiation therapy. Int J Radiat Oncol Biol Phys 52(5):1180–1185CrossRefPubMed McQuellon RP, Moose DB, Russell GB, Case LD, Greven K, Stevens M et al (2002) Supportive use of megestrol acetate (Megace) with head/neck and lung cancer patients receiving radiation therapy. Int J Radiat Oncol Biol Phys 52(5):1180–1185CrossRefPubMed
16.
Zurück zum Zitat Farmer M, Case D, Lesser G, Monitto D, Smathers S, May B et al (2005) A phase III, double blind, placebo-controlled, prospective randomized trial on the effect of megestrol acetate on weight and health related quality of life in lung cancer and head and neck cancer patients receiving curative radiation therapy. Int J Radiat Oncol Biol Phys 63:S77–S78 Farmer M, Case D, Lesser G, Monitto D, Smathers S, May B et al (2005) A phase III, double blind, placebo-controlled, prospective randomized trial on the effect of megestrol acetate on weight and health related quality of life in lung cancer and head and neck cancer patients receiving curative radiation therapy. Int J Radiat Oncol Biol Phys 63:S77–S78
17.
Zurück zum Zitat Daly JM, Hearne B, Dunaj J, LePorte B, Vikram B, Strong E et al (1984) Nutritional rehabilitation in patients with advanced head and neck cancer receiving radiation therapy. Am J Surg 148:514–520CrossRefPubMed Daly JM, Hearne B, Dunaj J, LePorte B, Vikram B, Strong E et al (1984) Nutritional rehabilitation in patients with advanced head and neck cancer receiving radiation therapy. Am J Surg 148:514–520CrossRefPubMed
18.
Zurück zum Zitat Ottery F (1996) Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition 12:s15–s19PubMed Ottery F (1996) Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition 12:s15–s19PubMed
19.
Zurück zum Zitat Isenring EA, Bauer JD, Capra S (2007) Nutrition support using the American Dietetic Association medical nutrition therapy protocol for radiation oncology patients improves dietary intake compared with standard practice. J Am Diet Assoc 107(3):404–412CrossRefPubMed Isenring EA, Bauer JD, Capra S (2007) Nutrition support using the American Dietetic Association medical nutrition therapy protocol for radiation oncology patients improves dietary intake compared with standard practice. J Am Diet Assoc 107(3):404–412CrossRefPubMed
20.
Zurück zum Zitat Berenstein EG, Ortiz Z (2005) Megestrol acetate for the treatment of anorexia-cachexia syndrome. Cochrane Database Syst Rev [2]:CD004310 Berenstein EG, Ortiz Z (2005) Megestrol acetate for the treatment of anorexia-cachexia syndrome. Cochrane Database Syst Rev [2]:CD004310
Metadaten
Titel
Nutritional support for head and neck cancer patients receiving radiotherapy: a systematic review
verfasst von
Shashank Garg
John Yoo
Eric Winquist
Publikationsdatum
01.06.2010
Verlag
Springer-Verlag
Erschienen in
Supportive Care in Cancer / Ausgabe 6/2010
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-009-0686-3

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