Abstract
The purpose of this paper is to investigate the possible role of immunonutrition in head and neck cancer patients. Malnutrition frequently occurs in head and neck oncological patients, due to mechanical obstruction, such as tumour induced cachexia, poor dietary habits, as well as excessive alcohol consumption. These defects combined with the immune suppressive effects of surgery have been claimed to contribute in increasing the postoperative complications rate, such as poor wound healing and higher incidence of infections. Immunonutrition has been proposed to provide specific benefits to the immune system; several clinical trials, also in head and neck cancer patients, are already present in the literature, even if methodological differences impede comparisons and firm conclusions so far. Nutritional oncology is a new and interesting field and requires the use of standardised intervention protocols in order to evaluate its clinical efficacy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Calder PC (2003) Immunonutrition. BMJ 327:117–118
Stableforth WD, Thomas S, Lewis SJ (2009) A systematic review of the role of immunonutrition in patients undergoing surgery for head and neck cancer. Int J Oral Maxillofac Surg 38:103–110
Moskovitz DN, Does Young-In K (2004) Perioperative immunonutrition reduce postoperative complications in patients with gastrointestinal cancer undergoing operations? Nutr Rev 62(11):443–447
Suchner U, Kuhn KS, Fürst P (2000) The scientific basis of immunonutrition. Proc Nutr Soc 59:553–563
Ameho CK, Adjei AA, Harrison EK, Takeshita K, Morioka T, Arakaki Y, Ito E, Suzuki I, Kulkarni AD, Kawajiri A, Yamamoto S (1997) Prophylactic effect of dietary glutamine supplementation on interleukin 8 and tumour necrosis factor alpha production in trinitrobenzene sulphonic acid induced colitis. Gut 41(4):487–493
Mañé J, Fernández-Bañares F, Ojanguren I, Castellá E, Bertrán X, Bartolí R, Alvarez M, Gassull MA (2001) Effect of l-arginine on the course of experimental colitis. Clin Nutr 20(5):415–422
Coëffier M, Marion-Letellier R, Déchelotte P (2010) Potential for amino acids supplementation during inflammatory bowel diseases. Inflamm Bowel Dis 16(3):518–524
Hayashi N, Tashiro T, Yamamori H, Takagi K, Morishima Y, Otsubo Y, Sugiura T, Furukawa K, Nitta H, Nakajima N, Suzuki N, Ito I (1999) Effect of intravenous omega-6 and omega-3 fat emulsions on nitrogen retention and protein kinetics in burned rats. Nutrition 15(2):135–139
Sugiura T, Tashiro T, Yamamori H, Takagi K, Hayashi N, Itabashi T, Toyoda Y, Sano W, Nitta H, Hirano J, Nakajima N, Ito I (1999) Effects of total parenteral nutrition on endotoxin translocation and extent of the stress response in burned rats. Nutrition 15(7,8):570–575
Hayashi N, Tashiro T, Yamamori H, Takagi K, Morishima Y, Otsubo Y, Sugiura T, Furukawa K, Nitta H, Nakajima N, Suzuki N, Ito I (1998) Effects of intravenous omega-3 and omega-6 fat emulsion on cytokine production and delayed type hypersensitivity in burned rats receiving total parenteral nutrition. J Parenter Enteral Nutr 22(6):363–367
Campos FG, Waitzberg DL, Logulo AF, Torrinhas RS, Teixeira WG, Habr-Gama A (2002) Immunonutrition in experimental colitis: beneficial effects of omega-3 fatty acids. Arq Gastroenterol 39(1):48–54
Campos FG, Waitzberg DL, Habr-Gama A, Logullo AF, Noronha IL, Jancar S, Torrinhas RS, Fürst P (2002) Impact of parenteral n-3 fatty acids on experimental acute colitis. Br J Nutr 87(Suppl 1):S83–S88
De Luis DA, Izaola O, Cuellar L, Terroba MC, Martin T, Aller R (2009) High dose of arginine enhanced enteral nutrition in postsurgical head and neck cancer patients: a randomized clinical trial. Eur Rev Med Pharmacol Sci 13(4):279–283
Sorensen D, McCarthy M, Baumgartner B, Demars S (2009) Perioperative immunonutrition in head and neck cancer. Laryngoscope 119(7):1358–1364
Casas-Rodera P, Gómez-Candela C, Benítez S, Mateo R, Armero M, Castillo R, Culebras JM (2008) Immunoenhanced enteral nutrition formulas in head and neck cancer surgery: a prospective, randomized clinical trial. Nutr Hosp 23(2):105–110
Hadden JW (1997) The immunopharmacology of head and neck cancer: an update. Int J Immunopharmac 19:629–644
Heyland DK, Novak F, Drover F, Jain M, Su X, Suchner U (2001) Should immunonutrition become routine in critically ill patients? a systematic review of the evidence. J Am Med Assoc 286:944–953
Riso S, Aluffi P, Brugnani M, Farinetti F, Pia F, D’Andrea F (2000) Postoperative enteral immunonutrition in head and neck cancer patients. Clin Nutr 19:407–412
van der Schueren MAE, Langendoen SI, Vondeling H, Kuik DJ, Quak JJ, van Leeuwen PAM (2000) Perioperative enteral nutrition and quality of life of severely malnourished head and neck cancer patients: a randomised clinical trial. Clin Nutr 19:437–444
van der Schueren MAE, Quak JJ, der Flier BME, Kuik DJ, Langendoen SI, Snow GB, Green CJ, van Leeuwen PAM (2001) Effect of perioperative nutrition, with and without arginine supplementation, on nutritional status, immune function, postoperative morbidity, and survival in severely malnourished head and neck cancer patients. Am J Clin Nutr 73:323–332
van der Schueren MAE, Van Leeuwen PA, Sauerwein S, Kuik DJ, Snow GB, Quak JJ (1997) Assessment of malnutritional parameters in head and neck cancer and their relationship to postoperative complications. Head Neck 19:419–425
O’Leary MJ, Coakley JH (1996) Nutrition and immunonutrition. British J Anaesth 77:118–127
Author information
Authors and Affiliations
Corresponding author
Additional information
A. Ciorba and C. Bianchini have equally contributed to the paper.
Rights and permissions
About this article
Cite this article
Bianchini, C., Ciorba, A., Stomeo, F. et al. Immunonutrition in head and neck cancer: have a look before surgery!. Eur Arch Otorhinolaryngol 269, 5–8 (2012). https://doi.org/10.1007/s00405-011-1725-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-011-1725-5