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Nutritional counseling for head and neck cancer patients undergoing (chemo) radiotherapy — a prospective randomized trial

2019-03-18Journal article Open access
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dc.contributor.authorOrell, Helena
dc.contributor.authorSchwab, Ursula
dc.contributor.authorSaarilahti, Kauko
dc.contributor.authorÖsterlund, Pia
dc.contributor.authorRavasco, Paula
dc.contributor.authorMäkitie, Antti
dc.date.accessioned2021-04-12T14:16:29Z
dc.date.available2021-04-12T14:16:29Z
dc.date.issued2019-03-18
dc.description.abstractBackground: Locally advanced head and neck cancer is managed either by combined surgery and (chemo) radiotherapy or definitive (chemo) radiotherapy, which may deteriorate nutritional status. Previous data have shown that intensive nutritional intervention by a dietician reduces radiation-induced adverse events including weight loss. Objective: To determine if on-demand nutritional counseling (ODC, control group) would be as efficacious as intensive nutritional counseling (INC, experimental group) in patients undergoing (chemo) radiotherapy. Methods: Fifty-eight patients were randomly assigned to receive INC (n = 26) or ODC (n = 32). Outcome measures were nutritional status (PG-SGA), weight loss, handgrip strength (HGS), body composition, and survival. Results: Weight loss and impaired nutritional 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 nutritional 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: As for our primary endpoint, individualized on-demand nutritional counseling was as efficacious as intensive counseling in preventing deterioration of nutritional status and incidence of malnutrition during (chemo) radiotherapy. This should be verified with larger number of patients. Additional findings were that overweight patients had more severe weight loss, but not poorer survival. Low HGS and malnutrition at baseline were associated with poor survival. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02159508.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.3389/fnut.2019.00022pt_PT
dc.identifier.eid85067802374
dc.identifier.issn2014-9999
dc.identifier.pmcPMC6432820
dc.identifier.pmid30937304
dc.identifier.urihttp://hdl.handle.net/10400.14/32495
dc.identifier.wos000463021200001
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectHandgrip strengthpt_PT
dc.subjectNutritional interventionpt_PT
dc.subjectNutritional statuspt_PT
dc.subjectSurvivalpt_PT
dc.subjectWeight losspt_PT
dc.titleNutritional counseling for head and neck cancer patients undergoing (chemo) radiotherapy — a prospective randomized trialpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleFrontiers in Nutritionpt_PT
oaire.citation.volume6pt_PT
person.familyNameSaarilahti
person.familyNameRavasco
person.givenNameKauko
person.givenNamePaula
person.identifier381093
person.identifier.ciencia-id2E1E-155A-9B23
person.identifier.orcid0000-0003-2332-9389
person.identifier.orcid0000-0002-6056-8269
person.identifier.scopus-author-id6603401031
person.identifier.scopus-author-id6602551513
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicatione4c78118-d5a7-4e96-bed8-88cd46f88d70
relation.isAuthorOfPublication2c8ebd2c-2f6d-4a0b-9271-dbe40af19875
relation.isAuthorOfPublication.latestForDiscoverye4c78118-d5a7-4e96-bed8-88cd46f88d70

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