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Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo)radiotherapy: a systematic review.

Abstract

BACKGROUND AND AIMS

We performed a systematic review to examine the effect of nutritional interventions on nutritional status, quality of life (QoL) and mortality in patients with head and neck squamous cell cancer (HNSCC) receiving radiotherapy or chemoradiotherapy.

METHODS

We searched Pubmed, EMBASE, CENTRAL and Cinahl from inception through January 3rd, 2012 to identify randomized controlled trials (RCTs) from a broad range of nutritional interventions in patients with HNSCC during (chemo)radiotherapy. Two reviewers independently assessed study eligibility and risk of bias, and extracted data.

RESULTS

Of 1141 titles identified, 12 study reports were finally included, describing 10 different studies with 11 interventions. Four out of 10 studies examined the effects of individualized dietary counseling, and showed significant benefits on nutritional status and QOL compared to no counseling or general nutritional advice by a nurse (p < 0.05). Three studies on oral nutritional supplements (ONS) were inconsistent about the effect on nutritional status compared with no supplementation. One study showed that nasogastric tube feeding had beneficial effects on nutritional status compared to ONS, but not in all patient groups (p < 0.04). One study showed benefits of percutaneous endoscopic gastronomy (PEG) feeding on nutritional status shortly after RT compared with nasogastric feeding (p = 0.001). Two studies showed that prophylactic PEG feeding was not superior over tube feeding if required.

CONCLUSIONS

This review shows beneficial effects of individualized dietary counseling on nutritional status and QoL, compared to no counseling or standard nutritional advice. Effects of ONS and tube feeding were inconsistent.

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  • Authors+Show Affiliations

    ,

    Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center Amsterdam, PO Box 7057, 1007 MB Amsterdam, The Netherlands. Electronic address: j.langius@vumc.nl.

    , , , , ,

    Source

    MeSH

    Adult
    Chemoradiotherapy
    Foods, Specialized
    Head and Neck Neoplasms
    Humans
    Malnutrition
    Nutritional Sciences
    Nutritional Status
    Nutritional Support
    Nutritionists
    Patient Education as Topic
    Precision Medicine
    Quality of Life
    Randomized Controlled Trials as Topic

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    23845384

    Citation

    Langius, Jacqueline A E., et al. "Effect of Nutritional Interventions On Nutritional Status, Quality of Life and Mortality in Patients With Head and Neck Cancer Receiving (chemo)radiotherapy: a Systematic Review." Clinical Nutrition (Edinburgh, Scotland), vol. 32, no. 5, 2013, pp. 671-8.
    Langius JA, Zandbergen MC, Eerenstein SE, et al. Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo)radiotherapy: a systematic review. Clin Nutr. 2013;32(5):671-8.
    Langius, J. A., Zandbergen, M. C., Eerenstein, S. E., van Tulder, M. W., Leemans, C. R., Kramer, M. H., & Weijs, P. J. (2013). Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo)radiotherapy: a systematic review. Clinical Nutrition (Edinburgh, Scotland), 32(5), pp. 671-8. doi:10.1016/j.clnu.2013.06.012.
    Langius JA, et al. Effect of Nutritional Interventions On Nutritional Status, Quality of Life and Mortality in Patients With Head and Neck Cancer Receiving (chemo)radiotherapy: a Systematic Review. Clin Nutr. 2013;32(5):671-8. PubMed PMID: 23845384.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo)radiotherapy: a systematic review. AU - Langius,Jacqueline A E, AU - Zandbergen,Myrna C, AU - Eerenstein,Simone E J, AU - van Tulder,Maurits W, AU - Leemans,C René, AU - Kramer,Mark H H, AU - Weijs,Peter J M, Y1 - 2013/06/26/ PY - 2013/02/06/received PY - 2013/05/30/revised PY - 2013/06/18/accepted PY - 2013/7/13/entrez PY - 2013/7/13/pubmed PY - 2014/4/17/medline KW - CRT KW - Dietary counseling KW - HNSCC KW - Head and neck cancer KW - Malnutrition KW - NG KW - ONS KW - PEG KW - QoL KW - RCT KW - RT KW - Radiotherapy KW - Tube feeding KW - Weight loss KW - chemoradiotherapy KW - head and neck squamous cell cancer KW - nasogastric KW - oral nutritional supplements KW - percutaneous endoscopic gastronomy KW - quality of life KW - radiotherapy KW - randomized controlled trial SP - 671 EP - 8 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 32 IS - 5 N2 - BACKGROUND AND AIMS: We performed a systematic review to examine the effect of nutritional interventions on nutritional status, quality of life (QoL) and mortality in patients with head and neck squamous cell cancer (HNSCC) receiving radiotherapy or chemoradiotherapy. METHODS: We searched Pubmed, EMBASE, CENTRAL and Cinahl from inception through January 3rd, 2012 to identify randomized controlled trials (RCTs) from a broad range of nutritional interventions in patients with HNSCC during (chemo)radiotherapy. Two reviewers independently assessed study eligibility and risk of bias, and extracted data. RESULTS: Of 1141 titles identified, 12 study reports were finally included, describing 10 different studies with 11 interventions. Four out of 10 studies examined the effects of individualized dietary counseling, and showed significant benefits on nutritional status and QOL compared to no counseling or general nutritional advice by a nurse (p < 0.05). Three studies on oral nutritional supplements (ONS) were inconsistent about the effect on nutritional status compared with no supplementation. One study showed that nasogastric tube feeding had beneficial effects on nutritional status compared to ONS, but not in all patient groups (p < 0.04). One study showed benefits of percutaneous endoscopic gastronomy (PEG) feeding on nutritional status shortly after RT compared with nasogastric feeding (p = 0.001). Two studies showed that prophylactic PEG feeding was not superior over tube feeding if required. CONCLUSIONS: This review shows beneficial effects of individualized dietary counseling on nutritional status and QoL, compared to no counseling or standard nutritional advice. Effects of ONS and tube feeding were inconsistent. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/23845384/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(13)00184-2 DB - PRIME DP - Unbound Medicine ER -