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Impact of early nutrition counseling in head and neck cancer patients with normal nutritional status

Supportive Care in Cancer volume 29, pages 2777–2785 (2021)Cite this article

Abstract

Background

Nutritional counseling is frequently overlooked in cancer patients with normal nutritional status. This study aimed to evaluate the impact of nutritional counseling in head and neck cancer (HNC) patients with normal nutritional status prior to concurrent chemoradiotherapy (CCRT).

Methods

A total of 243 patients with pretreatment normal nutritional status and locally advanced HNC receiving concurrent chemoradiotherapy (CCRT) at three medical centers were enrolled. All patients were retrospectively allocated into the early (≤ 2 weeks, n = 105, 43.2%), late (> 2 weeks, n = 102, 42.0%), and no nutritional counseling groups (n = 36, 14.8%) according to the time interval between the date of CCRT initiation and the first date of nutritional counseling for comparison.

Results

The 1-year overall survival rates were 95.0%, 87.5%, and 81.3% in the early, late, and no nutritional counseling groups (p = 0.035), respectively. The median body weight changes at end of CCRT were − 4.8% (range, − 13.3 to 8.7%), − 5.6% (range, − 21.9 to 5.6%), and − 8.6% (range, − 20.3 to 2.4%) in patients in the early, late, and no nutritional counseling groups, respectively. The early termination of chemotherapy rates and the incompletion rates of planned radiotherapy were 1.9% and 1.9%, 2.9%, and 2.0%, 13.9%, and 19.4% in patients in the early, late, and no nutritional counseling groups, respectively.

Conclusions

Our findings strongly suggest that while some HNC patients may have pretreatment normal nutritional status, early nutritional counseling is nevertheless essential for the improvement of treatment tolerance and survival outcome.

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Acknowledgments

The authors gratefully acknowledge the patients who participated in this study with the support from the Cancer Center of Chang Gung Memorial Hospital.

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Affiliations

  1. Department of Hematology and Oncology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, No. 5, Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan

    Ya-Wen Ho, Chia-Yen Hung, Hung-Ming Wang, Yu-Shin Hung & Wen-Chi Chou

  2. School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Ya-Wen Ho

  3. Department of Oncology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan

    Kun-Yun Yeh & Shun-Wen Hsueh

  4. Division of Hema-oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan

    Chia-Yen Hung

  5. Department of Oncology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan

    Chang-Hsien Lu

  6. Department of Radiation Oncology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, Taiwan

    Ngan-Ming Tsang

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  1. Ya-Wen Ho
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Correspondence to Wen-Chi Chou.

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Ho, YW., Yeh, KY., Hsueh, SW. et al. Impact of early nutrition counseling in head and neck cancer patients with normal nutritional status. Support Care Cancer 29, 2777–2785 (2021). https://doi.org/10.1007/s00520-020-05804-3

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  • DOI: https://doi.org/10.1007/s00520-020-05804-3

Keywords

  • Chemoradiotherapy
  • Head and neck cancer
  • Nutritional counseling
  • Treatment interruption