nutrition_dysphagie

Nutrition impact symptoms as prognostic indicators in gastric cancer: the role of quality of life and survival outcomes

Wed, 02 Jul 2025 00:00:00 +0000

BMC Cancer. 2025 Jul 1;25(1):1037. doi: 10.1186/s12885-025-14421-4.

ABSTRACT

BACKGROUND: Nutrition impact symptoms (NIS) are common among cancer patients and influence prognosis. This study aimed to investigate the prognostic significance of NIS in gastric cancer patients using data from the Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) database.

METHODS: We conducted a retrospective cohort study using data from 2,673 adult patients with confirmed gastric cancer enrolled in the INSCOC database between January 2013 to February 2020. NIS, including appetite loss, vomiting, dysphagia, and early satiety, were assessed using the Patient-Generated Subjective Global Assessment (PG-SGA). Overall survival (OS) was the primary outcome, while quality of life (QoL) was the secondary outcome. Statistical analyses included Kaplan-Meier survival analysis, Cox proportional hazards regression, and propensity score matching (PSM) to reduce confounding.

RESULTS: Patients with NIS had significantly worse OS compared to those without (median OS: 74.1 vs. 81.3 months, p < 0.001). In multivariate analysis, NIS was an independent predictor of mortality (HR: 1.28, 95% CI: 1.11-1.48, p = 0.001). Vomiting and dysphagia were particularly associated with increased mortality (HR: 1.22, p = 0.038 and HR: 1.80, p < 0.001, respectively). Interaction analysis revealed that the prognostic impact of NIS was influenced by chemotherapy (P for interaction = 0.002). NIS was also strongly associated with severe malnutrition. Sensitivity analysis confirmed the robustness of these findings, even after excluding short-term mortalities within 180 days.

CONCLUSIONS: NIS are significant independent predictors of poor prognosis in gastric cancer patients, contributing to malnutrition and reduced survival. These findings highlight the importance of early symptom recognition and nutritional intervention to potentially improve outcomes for gastric cancer patients.

TRIAL REGISTRATION: https://www.chictr.org.cn/showproj.html?proj=31813 , identifier ChiCTR1800020329.

PMID:40597891 | PMC:PMC12211481 | DOI:10.1186/s12885-025-14421-4

Wound Healing in a Glottic Cancer Patient: A Case Report on Nutritional Intervention

Sat, 28 Jun 2025 08:22:02 +0000

Author Names: Alsulami S.,Aljeldah T.,Aldossari A.

Database Source: Embase Weekly Updates

Journal Title: Journal of Pioneering Medical Sciences

Article Title: Wound Healing in a Glottic Cancer Patient: A Case Report on Nutritional Intervention

Year: 2025

Issue: Special Issue 1

Volume: 14

Abstract: Background: Advanced glottic cancer often poses significant challenges in postoperative wound healing after total laryngectomy and radiation. Case Presentation: A 76-year-old male diagnosed with T3N0M0 glottic cancer experienced severe wound-healing complications, including a pharyngocutaneous fistula (PCF) and persistent wound dehiscence, after undergoing extensive surgery and radiation therapy. Management and Outcome: A tailored nutritional intervention involving arginine supplementation was introduced to support tissue repair for four weeks. Arginine was selected for its role in stimulating collagen synthesis and enhancing immune function. This approach resulted in substantial improvement in wound healing and overall recovery. Discussion(s): This case demonstrates the role of arginine supplementation in supporting wound healing and recovery in cancer patients after surgery and radiation. By enhancing collagen synthesis, immune function and tissue repair, arginine provides a targeted nutritional strategy for improving postoperative outcomes. Copyright © 2025 the Author(s).

L-Carnitine to Reduce Chemoradiotherapy-Induced Toxicity in Head and Neck Cancer: A Randomized Study

Sat, 28 Jun 2025 08:22:02 +0000

Author Names: Puja K.,Singh K.,Yadav I.,Arya A.K.

Database Source: Embase Weekly Updates

Journal Title: Head and Neck

Article Title: L-Carnitine to Reduce Chemoradiotherapy-Induced Toxicity in Head and Neck Cancer: A Randomized Study

Year: 2025

Issue:

Volume:

Abstract: Background: Treatment related toxicities for management of cancer lead to significant deterioration in the quality of life, increased morbidity, hospital admissions, and increased treatment interruptions. We carried out this study, to reduce treatment related toxicities without compromising treatment efficacy. Objective(s): Evaluate L-carnitine in reducing toxicities in HNSCC patients undergoing concurrent chemoradiation. Methodology: Study conducted in the Department of Radiotherapy tertiary care center in Northern India from August 2018 to 2020. All patients were randomized into the study arm and control arm; the study arm received oral L-carnitine 500 mg thrice daily, with symptomatic treatment for chemoradiotherapy-induced toxicity. The control arm received only symptomatic treatment for chemoradiation-induced toxicities. Toxicity assessment was done biweekly during treatment using RTOG (Radiation Therapy Oncology Group) criteria for toxicity assessment. Nutritional assessment was done by comparing hemoglobin, albumin, and weight loss during treatment. Fatigue was assessed using the Brief Fatigue Inventory (BFI) and the quality of life was assessed using the EORTC-QLQ-C30 questionnaire. Response evaluation for the primary tumor and neck nodes was done using RECIST 1.1. Result(s): Significant decrease in severity and delay in onset of dermatitis, mucositis, laryngeal reactions, and dysphagia were observed; however, no such benefit was seen in xerostomia. Treatment response was comparable in both arms. Mean post-treatment BFI in the test arm versus control arm was 37.22 and 52.24 (p-value 0.042), respectively. 28.75% of patients in the control arm and none in the study arm had albumin levels < 3.4 g/dL. Median weight loss in the test arm was 5.2% and in the control arm was 7.4%. Hospital admission was significantly less in the test arm. Conclusion(s): L-carnitine can be given to HNSCC patients receiving concurrent chemoradiation to lessen treatment related toxicity, but larger, multicentric randomized trials required to substantiate this conclusion. Copyright © 2025 Wiley Periodicals LLC.

Exploration of a remote swallowing training model after laryngeal cancer surgery: Non-randomized concurrent controlled trial

Sat, 28 Jun 2025 08:22:02 +0000

Author Names: Li N.,Guo W.,Hu Z.,Huang Z.,Huang J.

Database Source: Embase Weekly Updates

Journal Title: Journal of telemedicine and telecare

Article Title: Exploration of a remote swallowing training model after laryngeal cancer surgery: Non-randomized concurrent controlled trial

Year: 2025

Issue:

Volume:

Abstract: BackgroundPatients with supraglottic laryngeal carcinoma need to receive swallowing rehabilitation training. During the COVID-19 pandemic, patients do not have the conditions to visit the hospital for follow up frequently, so it is imperative to explore a new remote rehabilitation training model based on network conditions.ObjectiveTo explore the effect of remote rehabilitation training mode on improving postoperative swallowing function in patients with supraglottic laryngeal carcinoma.MethodsPatients undergoing remote rehabilitation and video rehabilitation after surgical treatment for supraglottic laryngeal cancer, 16 each, were collected, and swallowing function at the start of transoral feeding was assessed as a baseline to compare swallowing function and the occurrence of complications at different stages of training.ResultsPatients in the remote group began to show significant improvement in subjective swallowing function from the second week (P < .001). In terms of objective swallowing function, although the remote group did not show a significant (P = .66) advantage initially, it was also significantly better than the control group in the fourth week (P<.001). These effects are even more impressive in patients undergoing open surgery (P<.001). When completed the rehabilitation phase, patients in the remote group had a better nutritional status (P = .03), especially postlaser surgery patients (P = .02).ConclusionsThe remote rehabilitation training model has an improving effect on patients with supraglottic laryngeal cancer postoperative swallowing disorder, which provides a theoretical basis for the design and improvement of the future remote rehabilitation training model. This study suggests that this training model should be incorporated into the daily postoperative management of patients with laryngeal cancer to improve the efficiency of patients' recovery, provide patients with real-time medical information, and relieve patients' anxiety, thus reducing the need for repeated visits and improving patients' postoperative quality of life.

Nutritional outcomes and impact of malnutrition in a randomised comparison between standard and prolonged time to surgery after neoadjuvant chemoradiotherapy for oesophageal cancer

Sat, 28 Jun 2025 08:22:02 +0000

Author Names: Ericson J.,Klevebro F.,Sunde B.,Szabo E.,Halldestam I.,Smedh U.,Wallner B.,Johansson J.,Johnsen G.,Aahlin E.K.,Johannessen H.-O.,Hjortland G.-O.,Lorentzen S.S.,Slott M.,Schroder W.,Rouvelas I.,Nilsson M.

Database Source: Embase Weekly Updates

Journal Title: European Journal of Surgical Oncology

Article Title: Nutritional outcomes and impact of malnutrition in a randomised comparison between standard and prolonged time to surgery after neoadjuvant chemoradiotherapy for oesophageal cancer

Year: 2025

Issue: 9

Volume: 51

Abstract: Background: Prolonged time to surgery (TTS) after neoadjuvant chemoradiotherapy (nCRT) may enable malnourished oesophageal cancer patients' nutritional status to recover better, possibly improving outcomes with fewer complications and better overall survival (OS) after oesophagectomy. Method(s): This is a substudy within a multicentre randomised controlled trial comparing outcomes in patients with oesophageal cancer after standard TTS of 4-6 weeks to prolonged TTS of 10-12 weeks after nCRT. Patients were categorised as malnourished or non-malnourished at baseline and compared regarding weight, dysphagia, postoperative complications, and OS. Result(s): The mean weight from baseline to time of surgery decreased significantly in patients allocated to standard TTS (p < 0.001) while patients with prolonged TTS recovered during the extended time to similar weight as at baseline (p = 0.131). The mean dysphagia score at the time of surgery improved significantly in both groups (p < 0.001). There were no significant differences between patients allocated to standard versus prolonged TTS regarding postoperative complications, regardless of malnourishment status at baseline. No significant differences in OS after prolonged TTS compared to standard TTS, was observed in neither malnourished patients (hazard ratio, HR 1.72 (95 %, CI: 0.82-3.59, p = 0.147) nor non-malnourished patients (HR 1.26 (95 % CI:0.82-1.94, p = 0.291). Conclusion(s): Prolonged TTS was associated with better weight recovery at the time of surgery compared to standard TTS. Patients malnourished at baseline did not benefit in terms of less postoperative complications after prolonged TTS. Copyright © 2025 The Authors

Normalcy of Swallowing in Head and Neck Cancer Patients Undergoing Particle Therapy Supported by Combined Swallowing Training and Feeding Management: A Randomised Controlled Trial.

Sun, 01 Jun 2025 04:00:00 +0000

Journal of Oral Rehabilitation; 06/01/2025
(AN 185398647); ISSN: 0305182X
CINAHL Complete

Analysis of the impact of minimally invasive esophagectomy on quality of life and functional prognosis in patients with esophageal squamous cell carcinoma: A retrospective comparative study

Fri, 30 May 2025 00:00:00 +0000

J Cardiothorac Surg. 2025 May 30;20(1):250. doi: 10.1186/s13019-025-03485-9.

ABSTRACT

BACKGROUND: Minimally invasive esophagectomy (MIE) has shown potential benefits in reducing postoperative complications and improving recovery for patients with esophageal squamous cell carcinoma (ESCC). This study aims to assess the effects of MIE on preoperative and postoperative quality of life and functional outcomes in ESCC patients.

METHODS: Clinical data from 57 ESCC patients who underwent MIE were retrospectively analyzed. Baseline characteristics, including age, gender, BMI, TNM stage, smoking history, alcohol consumption, comorbidities, tumor location, differentiation, and lymph node metastasis, were collected. Postoperative quality of life scores, nutritional status, and functional outcomes were assessed. Paired t-tests and chi-square tests were used to compare preoperative and postoperative variables, while correlation analysis was conducted to evaluate associations between functional outcomes and quality of life.

RESULTS: A total of 57 patients (41 males, 16 females; mean age: 67.61 ± 7.72 years) who underwent MIE were analyzed. Postoperative evaluation demonstrated significant improvements in quality of life scores across multiple dimensions, including physical symptoms (P = 0.006), emotional management (P = 0.013), role function (P = 0.013), cognitive function (P = 0.042), and social function (P = 0.021). Additionally, nutritional status improved postoperatively, with higher albumin levels (4.12 ± 0.34 g/dL vs. 3.78 ± 0.25 g/dL, P < 0.001) and reduced weight loss (1.98 ± 1.02 kg vs. 2.44 ± 1.12 kg, P = 0.026). Functional outcomes also showed significant improvements, including decreased dysphagia scores (3.45 ± 1.56 vs. 4.04 ± 0.31, P = 0.008), while cardiac physical activity and respiratory function remained stable (P > 0.05). Correlation analysis indicated significant associations between specific functional outcomes and quality of life (P < 0.05).

CONCLUSION: MIE improves quality of life, nutritional status, and functional outcomes in patients with esophageal squamous cell carcinoma, highlighting its potential benefits in postoperative recovery and patient well-being.

TRIAL REGISTRATION: Not applicable.

PMID:40448148 | PMC:PMC12123707 | DOI:10.1186/s13019-025-03485-9

Assessing the Impact of Removable Prosthetic Restorations on Nutritional Habits in Edentulous Patients Following Surgery for Head and Neck Cancer.

Thu, 01 May 2025 04:00:00 +0000

Nutrients; 05/01/2025
(AN 185133084); ISSN: 20726643
CINAHL Complete

Assessing the Impact of Nutritional Status on the Quality of Life in Head and Neck Cancer Patients—The Need for Comprehensive Digital Tools.

Tue, 01 Apr 2025 04:00:00 +0000

Cancers; 04/01/2025
(AN 184443234); ISSN: 20726694
CINAHL Complete

Percutaneous Endoscopic Gastrostomy in the 21st Century-An Overview of 1415 Consecutive Dysphagic Adult Patients

Thu, 13 Mar 2025 00:00:00 +0000

Nutrients. 2025 Feb 20;17(5):747. doi: 10.3390/nu17050747.

ABSTRACT

Background/Objectives: Percutaneous endoscopic gastrostomy (PEG) is recommended for long-term enteral nutrition in dysphagic patients. This study aims to characterize conditions motivating PEG, assess nutritional status on the gastrostomy day, evaluate survival and search for survival predictors. Methods: Retrospective study of adult patients who underwent PEG in a tertiary hospital from 2001 to 2023. Data collected included demographics, underlying disorders, nutritional status (anthropometry/laboratory evaluation) on the day of PEG and survival recorded until death or December 2023. Multivariable analysis was performed with Cox regression to search for survival predictors. Results: A total of 1415 patients were included (61.8% males, mean age 66.9 years); 66.4% presented a neurological disorder and 31.3% head and neck or esophageal cancers (HNC/EC). The mean BMI was 20.9 kg/m², with 49.8% underweight. Albumin, transferrin and total cholesterol were low at 43.2%, 62.2% and 50%, respectively. Median overall survival was 11.1 months; 14.1% of deaths occurred within 4 weeks. HNC/EC patients showed lower survival than neurological patients. Potentially regressive neurological conditions presented longer survival than progressive ones. Predictors of increased survival included female gender, younger age, higher albumin and higher BMI. The protective effect of BMI and albumin was more pronounced in males than in females. Conclusions: Neurological disorders were the most frequent underlying conditions. Nearly half of the patients displayed malnutrition before PEG feeding. Although PEG-fed patients displayed a considerable median survival time, some died early without benefit from PEG. Patients with potentially regressive neurological conditions presented better outcomes. Female gender, younger age, higher albumin and higher BMI were associated with longer survival.

PMID:40077616 | PMC:PMC11902068 | DOI:10.3390/nu17050747

Dysphagia, nutritional status, and quality of life in patients with head and neck cancer undergoing radiotherapy alone or combined with chemotherapy: an observational study

Fri, 07 Mar 2025 00:00:00 +0000

BMC Cancer. 2025 Mar 7;25(1):416. doi: 10.1186/s12885-025-13695-y.

ABSTRACT

INTRODUCTION: Radiotherapy (RT) is the most common nonsurgical treatment for head and neck cancer (HNC) and may or may not be combined with chemotherapy (CT). Dysphagia, characterized by impaired swallowing function, is one of the most common side effects of RT, occurring during and after RT, and may persist long after treatment.

OBJECTIVE: To compare the evolution of dysphagia, nutritional status, and quality of life (QoL) in the periods immediately before and after RT for HNC in individuals who received only RT or combined RT/CT.

METHODS: Prospective longitudinal observational study performed in a hospital of the Brazilian public health system. The individuals were allocated into two groups: RG (n = 20), consisting of patients who received only RT for HNC, and RCG (n = 27), who received RT plus CT. The patients were evaluated before and after RT to identify and classify dysphagia (PARD protocol), anthropometric variables (BMI, triceps skinfold thickness, arm and calf circumferences, and manual dynamometry), and QoL (QLC-30 and H&N-35 questionnaires).

RESULTS: The groups were homogeneous in demographic characteristics and tumor stage. RCG showed a higher proportion of worsening dysphagia severity (p < 0.01) and worsening of anthropometric assessment (p < 0.05). A negative correlation was observed between the initial-final change in dysphagia and the change in BMI for the total sample (rho=-0.379, p < 0.05). QoL worsened in most domains evaluated, but RCG showed additional worsening in the domains of global health and nausea and vomiting (p < 0.05).

CONCLUSION: RT for HNC leads to the early development of dysphagia, which can adversely affect nutritional status and QoL. Including CT in the RT regimen leads to a more accentuated worsening of the evaluated parameters.

PMID:40055649 | PMC:PMC11887319 | DOI:10.1186/s12885-025-13695-y

Percutaneous Endoscopic Gastrostomy in the 21st Century—An Overview of 1415 Consecutive Dysphagic Adult Patients.

Sat, 01 Mar 2025 05:00:00 +0000

Nutrients; 03/01/2025
(AN 183648286); ISSN: 20726643
CINAHL Complete

Normalcy of Swallowing in Head and Neck Cancer Patients Undergoing Particle Therapy Supported by Combined Swallowing Training and Feeding Management: A Randomised Controlled Trial

Thu, 27 Feb 2025 00:00:00 +0000

J Oral Rehabil. 2025 Jun;52(6):847-858. doi: 10.1111/joor.13939. Epub 2025 Feb 27.

ABSTRACT

OBJECTIVE: As a common complication following particle therapy for head and neck cancer (HNC), dysphagia poses significant risks and adverse outcomes for patients. This study aims to investigate the efficacy of an evidence-based combined regimen of feeding management and swallowing training on improving swallowing function, swallowing-related quality of life and nutritional status in patients with dysphagia.

METHODS: We conducted a randomised parallel-controlled trial at the Shanghai Proton and Heavy Ion Center from March 2023 to October 2023. The study included patients aged 18 or older with HNCs undergoing particle therapy, with or without concurrent chemotherapy. Patients with dysphagia caused by conditions other than cancer were excluded. Patients were randomly assigned to intervention or control groups. The control group received routine radiotherapy care during and 3 months post-treatment, while the intervention group received an additional combined regimen of feeding management and swallowing training. The control group received standard radiotherapy care during treatment and for 3 months post-treatment. In addition, the intervention group was instructed to undergo preventive swallowing training at the start of treatment, with feeding management measures (adjusting food texture, bite size, eating speed, posture and utensils) implemented once swallowing discomfort occurred. Swallowing function was assessed using the Eating Assessment Tool-10 (EAT-10). Swallowing-related quality of life was measured with the M.D. Anderson Dysphagia Inventory (MDADI), which covers emotional, functional, physical and global dimensions. Nutritional status was evaluated based on Body Mass Index (BMI) and the Nutrition Risk Screening 2002 (NRS2002). Assessments were performed at baseline, immediately post-treatment (within 3 days after completion of treatment) and 3 months post-treatment.

RESULTS: Ninety-six patients were enrolled in this study, with 48 in the intervention group and 48 in the control group. Group effect analysis revealed that the intervention group outperformed the control group in improving swallowing function (p = 0.002) and overall swallowing-related quality of life (p = 0.001). Time effects also indicated improvements in swallowing function and quality of life in the intervention group compared to baseline (p < 0.001), with no significant interaction effect (p > 0.05). Specifically, improvements were observed in the functional dimension (p < 0.001) and physical dimension (p < 0.001) of swallowing-related quality of life in the intervention group. The MDADI total scores showed a clinically significant difference (> 10 points) between groups. However, no significant between-group differences were found in BMI values (p = 0.474) or NRS2002 scores (p = 0.957).

CONCLUSION: Our study indicates that combining feeding management and swallowing training effectively enhances swallowing function and quality of life in HNC patients receiving particle therapy. However, insufficient evidence was found to support its impact on nutritional status or malnutrition risk.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: ChiCTR2300067550.

PMID:40013496 | DOI:10.1111/joor.13939

Dysphagia and quality of life in older adults receiving home‐based medical care.

Sat, 01 Feb 2025 05:00:00 +0000

Geriatrics & Gerontology International; 02/01/2025
(AN 183691477); ISSN: 14441586
CINAHL Complete

Malnutrition in patients with advanced head and neck cancer: Exploring the Global Leadership Initiative on Malnutrition (GLIM) criteria, energy balance and health-related quality of life

Sat, 01 Feb 2025 00:00:00 +0000

Clin Nutr ESPEN. 2025 Apr;66:332-342. doi: 10.1016/j.clnesp.2025.01.049. Epub 2025 Jan 30.

ABSTRACT

BACKGROUND & AIMS: Head and neck cancer (HNC) involves several tumor locations, the most common of which are the oropharynx and oral cavity. Patients with HNC are at high risk of developing malnutrition. Together with treatment, the tumor location contributes to difficulties in eating and swallowing, which can lead to a negative energy balance and weight loss. This study aimed to examine malnutrition via the Global Leadership Initiative on Malnutrition (GLIM) criteria, explore the different combinations of the GLIM criteria, study changes in body composition and body energy content and evaluate health-related quality of life (HRQoL) in patients with locally advanced HNC.

METHODS: Malnutrition was diagnosed via the GLIM criteria. Body weight, muscle mass, body fat, C-reactive protein (CRP) levels, energy intake, use of enteral feeding tubes or parenteral nutrition were assessed, and HRQoL scales from the European Organization for Research and Treatment of Cancer (EORTC), including the Quality of Life Questionnaire-Core 30 (QLQ-C30) and the Quality of Life Questionnaire-Head and Neck 35 (QLQ-HN35), and the M.D. Anderson Dysphagia Inventory (MDADI) were completed at baseline, 6 weeks and at 3, 6 and 12 months after the start of treatment. Body composition was measured via dual-energy X-ray absorptiometry, and body energy content was calculated.

RESULTS: Eighty patients were included. The prevalence of malnutrition varied over time and peaked at the end of treatment at 71 %, and at this time, the most common combination of the GLIM criteria was weight loss + reduced food intake + inflammation (31 %), followed by weight loss + reduced muscle mass + reduced food intake + inflammation (20 %). At the end of treatment patients were in a negative energy balance, and compared to baseline, body weight, body fat, and muscle mass had decreased with 6.0 % (p<0.0001), 5.9 % (p<0.0001), and 8.0 % (p<0.0001) respectively. At the 3-month follow-up, the reduction in muscle mass had ceased, despite a negative energy balance, and patients started to regain muscle mass. At 12 months body weight had decreased with 7.4 % (p<0.0001), body fat with 18.9 % (p<0.0001), and muscle mass with 2.4 % (p<0.0001) compared to baseline. Patients with malnutrition reported significantly worse HRQoL on a majority of the 16 quality of life scales at all time points, except at the end of treatment, when no significant differences were found between malnourished and nonmalnourished patients.

CONCLUSIONS: Patients with advanced HNC receiving combined treatment experience major nutritional problems, and malnutrition is common at the end of treatment. Inflammation-driven muscle depletion during treatment is challenging, but it seems possible to recover muscle mass after treatment. Patients with malnutrition reported worse HRQoL at all time points, except at the end of treatment, when all patients' quality of life was very negatively affected.

PMID:39892786 | DOI:10.1016/j.clnesp.2025.01.049

Novel nutrition strategies in gastric and esophageal cancer

Sun, 26 Jan 2025 00:00:00 +0000

Expert Rev Gastroenterol Hepatol. 2025 Jan-Feb;19(2):89-104. doi: 10.1080/17474124.2025.2457444. Epub 2025 Jan 30.

ABSTRACT

INTRODUCTION: Advances in treatment strategies for gastric and esophageal cancer have led to improved long-term outcomes, however the local and systemic effects of the primary tumor, neoadjuvant therapies and surgery, result in specific nutritional challenges. Comprehensive nutritional evaluation and support represents a core component of multidisciplinary holistic care for this patient population.

AREAS COVERED: We provide a detailed overview of nutritional challenges in gastric and esophageal cancer, with a focus on malignant obstruction, preoperative optimization and survivorship. We discuss current management strategies and evidence base, and describe future therapeutic targets.

EXPERT OPINION: Data to support the optimal management of malignant dysphagia and obstruction, particularly regarding patient reported outcomes, is currently lacking. The advantages of nutritional optimization in the pre- and immediate postoperative phase are well described, but further research is needed to inform optimal personalised strategies. Emerging data regarding the physiologic regulation of appetite and body weight have provided key insights and informed the development of novel therapeutic targets to improve nutritional status among patients undergoing treatment for oesophageal and gastric cancer.

PMID:39864091 | DOI:10.1080/17474124.2025.2457444

Prevalence and Risk Factors of Oropharyngeal Dysphagia in Newly Diagnosed Head-and-Neck Cancer Patients.

Wed, 01 Jan 2025 05:00:00 +0000

Cancers; 01/01/2025
(AN 182451798); ISSN: 20726694
CINAHL Complete

叙事心理疗法在喉癌外科治疗后吞咽障碍患者营养管理中的应用.

Sun, 01 Dec 2024 05:00:00 +0000

Chinese Journal of Convalescent Medicine / Zhongguo Liaoyang Yixue; 12/01/2024
(AN 181080988); ISSN: 1005619X
CINAHL Complete

Addressing Inflammaging and Disease-Related Malnutrition: Adequacy of Oral Nutritional Supplements in Clinical Care.

Sun, 01 Dec 2024 05:00:00 +0000

Nutrients; 12/01/2024
(AN 181658805); ISSN: 20726643
CINAHL Complete

Integrative multi-omics and big data analysis of global nutrition and radiotherapy trends

Sun, 10 Nov 2024 00:00:00 +0000

Int J Biochem Cell Biol. 2024 Dec;177:106687. doi: 10.1016/j.biocel.2024.106687. Epub 2024 Nov 8.

ABSTRACT

BACKGROUND: Radiotherapy serves as a crucial modality in cancer treatment, frequently synergizing with other therapies to enhance patient outcomes. Unfortunately, radiotherapy is often accompanied by nutritional impairments, including dysphagia and malnutrition, which hinder patient recovery and treatment efficacy. Moreover, nutritional abnormalities accompanied by metabolic reprogramming may lead to alterations across multiple omics domains. Consequently, big data analysis on radiotherapy and nutrition is imperative.

OBJECTIVE: This study employs bibliometric analysis to visually showcase the current research landscape and trending hotspots in the intersection of nutrition and radiotherapy.

METHODS: Leveraging the Web of Science Core Collection, we screened and analyzed 4379 publications related to nutrition and radiotherapy published between 2004 and 2023. Utilizing VOSviewer, Bibliometrix, and Citespace software, we conducted bibliometric analysis and visualization of countries, institutions, authors, and keywords.

RESULTS: Our analysis reveals a substantial increase in publications concerning nutrition and radiotherapy, with the United States and China leading in both publication volume and citation impact. The research focus has gradually shifted from phenomenological studies to mechanistic investigations, as evidenced by changes in keyword usage. While confirming the influence of nutritional status on radiotherapy outcomes, we also identified potential links to genomics, proteomics, metabolomics, and other omics disciplines.

CONCLUSION: This study emphasizes the growing attention to the interplay between nutrition and radiotherapy in cancer treatment. Our findings suggest that further integration of multi-omics analysis can enhance understanding of the mechanisms underlying these interactions, providing a foundation for advancing cancer diagnosis and treatment strategies in the future.

PMID:39522934 | DOI:10.1016/j.biocel.2024.106687

How enteral nutrition modes influence nasopharyngeal carcinoma survivors with late dysphagia after radiotherapy: a randomized controlled study

Fri, 04 Oct 2024 00:00:00 +0000

Support Care Cancer. 2024 Oct 5;32(10):702. doi: 10.1007/s00520-024-08912-6.

ABSTRACT

BACKGROUND: Palliation to late dysphagia after radiotherapy for nasopharyngeal carcinoma (NPC) continues to be a challenge. Intermittent oro-esophageal tube feeding (IOE) is an emerging enteral nutrition mode that can address nutrition and quality of life issues related to nasogastric tube feeding (NGT).

OBJECTIVES: This study aims to investigate the effect of IOE versus NGT in late dysphagia after radiotherapy for NPC.

METHODS: This randomized controlled study included 82 NPC survivors with late dysphagia after radiotherapy. The subjects were randomized divided into the IOE and NGT groups (n1 = n2 = 41). Both groups received standard-of-care rehabilitation. Enteral nutrition supports were administered through IOE or NGT accordingly. This study lasted 2 weeks for each participant. The primary outcome was nutritional status including albumin, hemoglobin, total serum protein, and body mass index. The secondary outcomes were (i) the functional oral intake scale (FOIS), (ii) the penetration-aspiration scale (PAS), (iii) oral transit time (OTT), (iv) hyoid pause time (HPT), (v) pharyngeal transport time (PTT), and (vi) swallowing-quality of life (SWAL-QoL).

RESULTS: Three cases quitted the study halfway and there were no significant baseline differences between the IOE (n = 40) and NGT (n = 39) groups. Both time and group effects were significant in all nutritional indicators. The time effect was significant in the FOIS levels, OTT and PTT, while the group effect was not. Either time or group effect were insignificant in the PAS levels and HPT. Both group and time effects were significant in the SWAL-QoL total scores (z_Group = 5.080, P < 0.001; z_Time = 18.005, P < 0.001). The significance of time and group effects varied across different dimensions of the SWAL-QoL.

CONCLUSIONS: Rehabilitation interventions can improve swallowing function among NPC survivors with late dysphagia after radiotherapy. In this population who received standard-of-care rehabilitation, IOE is more conducive to the improvement of nutritional status, and swallowing-related quality of life.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06301763.

PMID:39367230 | DOI:10.1007/s00520-024-08912-6

The Importance of Nutrition in Cancer Care: A Narrative Review

Sun, 15 Sep 2024 00:00:00 +0000

Curr Nutr Rep. 2024 Dec;13(4):950-965. doi: 10.1007/s13668-024-00578-0. Epub 2024 Sep 15.

ABSTRACT

PURPOSE OF REVIEW: Cancer, a complex disease affecting millions globally, presents considerable challenges for both patients and health care providers. Within the broad spectrum of cancer care, nutrition plays a key role in supporting patients throughout their journey. This narrative review examines the role of nutrition in cancer care, exploring its impact on treatment outcomes, nutritional status, current dietary recommendations, physical activity, palliative care, and finally, as a nutritional encouragement for cancer survivors.

RECENT FINDINGS: Evidence indicates that cancer and anticancer treatments frequently cause malnutrition and loss of muscle mass, which can exacerbate symptoms, impair immune function, and hamper recovery. Therefore, adequate nutritional support is crucial for maintaining strength, controlling symptoms, and optimizing treatment tolerance in patients with cancer. Several factors influence nutritional needs and dietary recommendations, including cancer type, treatment, and individual patient characteristics. Nutritional care aims not only to ensure sufficient energy and protein intake, but also to manage specific symptoms such as dysgeusia, nausea, and dysphagia. Registered dietitians play a crucial role in providing personalized nutritional guidance, monitoring nutritional status, and implementing interventions to address emerging challenges in cancer care. Furthermore, recent research has underscored the benefits of dietary interventions in cancer treatment. From targeted nutritional supplements to more invasive nutritional support, interest in how nutrition can affect cancer risk and treatment outcomes is increasing. Overall, this review highlights the critical role of nutritional care in comprehensive cancer treatment. By recognizing and meeting dietary demands throughout the entire cancer journey, health care professionals can improve patients' well-being, response to treatment, and long-term prognosis.

PMID:39278864 | DOI:10.1007/s13668-024-00578-0

Development of a Dysphagia Pathway Program for Head and Neck Cancer in a Rural Patient Population.

Thu, 01 Aug 2024 04:00:00 +0000

Perspectives of the ASHA Special Interest Groups; 08/01/2024
(AN 178830668); ISSN: 2381473X
CINAHL Complete

Nutritional care in older adults: are we doing everything? An expert opinion review

Wed, 24 Jul 2024 00:00:00 +0000

Curr Med Res Opin. 2024 Sep;40(9):1563-1576. doi: 10.1080/03007995.2024.2380007. Epub 2024 Aug 1.

ABSTRACT

Malnutrition is a prevalent, yet often underdiagnosed and undertreated, condition in older adults. It is characterized by weight loss and/or reduced muscle mass due to diminished caloric intake, inflammation, and/or disease burden. In return, malnutrition can lead to diminished skeletal muscle functionality and disability, among others. Malnutrition plays a crucial role in the pathogenesis of two prevalent geriatric syndromes, namely sarcopenia and frailty. The complex interplay between malnutrition, sarcopenia, and frailty significantly impacts the older population, leading to increased morbidity, mortality, hospitalization rates, quality-of-life, and healthcare costs. Given the prognostic significance of malnutrition in geriatric care, recent guidelines emphasized the role of nutritional support in vulnerable populations. A group of vulnerable populations to malnutrition, sarcopenia, and frailty are older patients with hip fractures, cancer patients, and those with sarcopenic dysphagia. This article highlights the importance of individualized nutritional assessment and treatment in the management of vulnerable populations such as older patients with hip fractures, cancer, and those suffering from sarcopenic dysphagia. It presents practical protocols and guidelines that can be instrumental in enhancing the nutritional care of these groups, thereby improving their overall health outcomes.

PMID:39044672 | DOI:10.1080/03007995.2024.2380007

Quality of Life and Nutritional Outcomes of Stomach-Preserving Surgery for Early Gastric Cancer: A Secondary Analysis of the SENORITA Randomized Clinical Trial

Wed, 29 May 2024 00:00:00 +0000

JAMA Surg. 2024 Aug 1;159(8):900-908. doi: 10.1001/jamasurg.2024.1210.

ABSTRACT

IMPORTANCE: The Sentinel Node Oriented Tailored Approach (SENORITA) randomized clinical trial evaluated quality of life (QoL) and nutritional outcomes between the laparoscopic sentinel node navigation surgery (LSNNS) and laparoscopic standard gastrectomy (LSG). However, there has been no report on the QoL and nutritional outcomes of patients who underwent stomach-preserving surgery among the LSNNS group.

OBJECTIVE: To compare long-term QoL and nutritional outcomes between patients who underwent stomach-preserving surgery and those who underwent standard gastrectomy and to identify factors associated with poor QoL outcomes in patients who underwent stomach-preserving surgery.

DESIGN, SETTING, AND PARTICIPANTS: This study is a secondary analysis of the SENORITA trial, a randomized clinical trial comparing LSNNS with LSG. Patients from 7 tertiary or general hospitals across the Republic of Korea were enrolled from March 2013 to December 2016, with follow-up through 5 years. Data were analyzed between August and September 2022. Among trial participants, patients who underwent actual laparoscopic standard gastrectomy in the LSG group and those who underwent stomach-preserving surgery in the LSNNS group were included. Patients who did not complete the baseline or any follow-up questionnaire were excluded.

INTERVENTION: Stomach-preserving surgery vs standard gastrectomy.

MAIN OUTCOMES AND MEASURES: Overall European Organization for Research and Treatment of Cancer QoL Questionnaire Core 30 (EORTC QLQ-C30) and stomach module (STO22) scores, body mass index, hemoglobin, protein, and albumin levels.

RESULTS: A total of 194 and 257 patients who underwent stomach-preserving surgery and standard gastrectomy, respectively, were included in this study (mean [SD] age, 55.6 [10.6] years; 249 [55.2%] male). The stomach-preserving group had better QoL scores at 3 months postoperatively in terms of physical function (87.2 vs 83.9), dyspnea (5.9 vs 11.2), appetite loss (13.1 vs 19.4), dysphagia (8.0 vs 12.7), eating restriction (10.9 vs 18.2), anxiety (29.0 vs 35.2), taste change (7.4 vs 13.0), and body image (19.5 vs 27.2). At 1 year postoperatively, the stomach-preserving group had significantly higher body mass index (23.9 vs 22.1, calculated as weight in kilograms divided by height in meters squared) and hemoglobin (14.3 vs 13.3 g/dL), albumin (4.3 vs 4.25 g/dL), and protein (7.3 vs 7.1 g/dL) levels compared to the standard group. Multivariable analyses showed that tumor location (greater curvature, lower third) was favorably associated with global health status (β, 10.5; 95% CI, 3.2 to 17.8), reflux (β, -8.4; 95% CI, -14.7 to -2.1), and eating restriction (β, -5.7; 95% CI, -10.3 to -1.0) at 3 months postoperatively in the stomach-preserving group. Segmental resection was associated with risk of diarrhea (β, 40.6; 95% CI, 3.1 to 78.1) and eating restriction (β, 15.1; 95% CI, 1.1 to 29.1) at 3 years postoperatively.

CONCLUSIONS AND RELEVANCE: Stomach-preserving surgery after sentinel node evaluation was associated with better long-term QoL and nutritional outcomes than standard gastrectomy. These findings may help facilitate decision-making regarding treatment for patients with early-stage gastric cancer.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01804998.

PMID:38809537 | PMC:PMC11137655 | DOI:10.1001/jamasurg.2024.1210

Assessing Nutritional Status in Gastric Cancer Patients after Total versus Subtotal Gastrectomy: Cross-Sectional Study

Sat, 25 May 2024 00:00:00 +0000

Nutrients. 2024 May 14;16(10):1485. doi: 10.3390/nu16101485.

ABSTRACT

Gastric cancer (GC) remains a significant global health concern, ranking as the third leading cause of cancer-related deaths. Malnutrition is common in GC patients and can negatively impact prognosis and quality of life. Understanding nutritional issues and their management is crucial for improving patient outcomes. This cross-sectional study included 51 GC patients who underwent curative surgery, either total or subtotal gastrectomy. Various nutritional assessments were conducted, including anthropometric measurements, laboratory tests, and scoring systems such as Eastern Cooperative Oncology Group/World Health Organization Performance Status (ECOG/WHO PS), Observer-Reported Dysphagia (ORD), Nutritional Risk Screening-2002 (NRS-2002), Patient-Generated Subjective Global Assessment (PG-SGA), and Simplified Nutritional Appetite Questionnaire (SNAQ). Serum carcinoembryonic antigen (CEA) levels were significantly higher in the subtotal gastrectomy group. Nutritional assessments indicated a higher risk of malnutrition in patients who underwent total gastrectomy, as evidenced by higher scores on ORD, NRS-2002, and PG-SGA. While total gastrectomy was associated with a higher risk of malnutrition, no single nutritional parameter emerged as a strong predictor of surgical approach. PG-SGA predominantly identified malnutrition, with its occurrence linked to demographic factors such as female gender and age exceeding 65 years.

PMID:38794723 | PMC:PMC11123703 | DOI:10.3390/nu16101485

Effect of nutrition impact symptoms on oral nutritional supplements energy intake and use days in patients with head and neck cancer: A cross-sectional study

Tue, 21 May 2024 00:00:00 +0000

Cancer Med. 2024 May;13(10):e7288. doi: 10.1002/cam4.7288.

ABSTRACT

BACKGROUND: This study aims to explore the effect of nutritional impact symptoms (NIS) on oral nutritional supplements (ONS) energy intake and use days among head and neck cancer (HNC) patients.

METHODS: A cross-sectional study was conducted among HNC patients in a hospital in western China between January 2019 and June 2020. The NIS was from the Patient-Generated Subjective Global Assessment (PG-SGA) scale. Mann-Whitney test was used to examine the differences between different kinds of NIS and ONS use days. Binary logistic regression was used to determine the effect of NIS on ONS energy intake.

RESULTS: The most prevalent four NIS were no appetite (35.3%), dysphagia (29.4%), vomiting (13.2%) and oral pain (12.5%), respectively. All patients in the study were malnutrition. Patients with xerostomia or oral pain had less ONS use days than those without these symptoms. Patients with vomiting (OR 0.09, 95% CI 0.02-0.50) or pain (OR 0.15, 95% CI 0.02-0.89) were less likely to have ONS energy intake ≥400 kcal/day than those without these symptoms after adjusting the confounding factors. In addition, one-point increase in total NIS score was associated with a lower proportion of ONS energy intake ≥400 kcal/day (OR 0.77, 95% CI 0.59-0.99).

CONCLUSION: Xerostomia, oral pain, vomiting and pain should be strengthened and intervened to improve ONS use and nutritional status among HNC patients with malnutrition.

PMID:38770538 | PMC:PMC11106646 | DOI:10.1002/cam4.7288

Assessing Nutritional Status in Gastric Cancer Patients after Total versus Subtotal Gastrectomy: Cross-Sectional Study.

Wed, 15 May 2024 04:00:00 +0000

Nutrients; 05/15/2024
(AN 177491590); ISSN: 20726643
CINAHL Complete

Nutritional Prognosis of Patients Submitted to Radiotherapy and Its Implications in Treatment

Sat, 11 May 2024 00:00:00 +0000

Nutrients. 2024 Apr 30;16(9):1363. doi: 10.3390/nu16091363.

ABSTRACT

Oncological patients show intense catabolic activity, as well as a susceptibility to higher nutritional risk and clinical complications. Thus, tools are used for monitoring prognosis. Our objective was to analyze the nutrition prognosis of patients who underwent radiotherapy, correlating it with outcomes and complications. We performed a retrospective transversal study based on secondary data from hospital records of patients who started radiotherapy between July 2022 and July 2023. We established Prognostic Scores through a combination of Prognostic Nutritional Index (PNI) and a Subjective Global Assessment (SGA), assessed at the beginning and end of treatment. Score 3 patients, with PNI ≤ 45.56 and an SGA outcome of malnutrition, initially presented a higher occurrence of odynophagia, later also being indicative of reduced diet volume, treatment interruption, and dysphagia. SGA alone showed sensitivity to altered diet volume, dysphagia, and xerostomia in the second assessment. Besides this, PNI ≤ 45.56 also indicated the use of alternative feeding routes, treatment interruption, and hospital discharge with more complications. We conclude that the scores could be used to indicate complications; however, further studies on combined biomarkers are necessary.

PMID:38732610 | PMC:PMC11085617 | DOI:10.3390/nu16091363

Nutritional Prognosis of Patients Submitted to Radiotherapy and Its Implications in Treatment.

Wed, 01 May 2024 04:00:00 +0000

Nutrients; 05/01/2024
(AN 177180003); ISSN: 20726643
CINAHL Complete

Association of perioperative oral swallowing function with post-esophagectomy outcomes and nutritional statuses in patients with esophageal cancer

Thu, 25 Apr 2024 00:00:00 +0000

Dis Esophagus. 2024 Jul 31;37(8):doae032. doi: 10.1093/dote/doae032.

ABSTRACT

Dysphagia after esophagectomy is a serious complication; however, no method has been established to accurately assess swallowing function. We evaluated the association of swallowing function tests with patients' post-esophagectomy complications and nutritional statuses. We retrospectively reviewed the data of 95 patients with esophageal cancer who underwent esophagectomy between 2016 and 2021. We performed perioperative swallowing function tests, including the repetitive saliva swallowing test (RSST), maximum phonation time (MPT), and laryngeal elevation (LE). Patients with recurrent laryngeal nerve palsy (RLNP) and respiratory complications (RC) had significantly lower postoperative RSST scores than patients without them; the scores in patients with or without anastomotic leakage (AL) were similar. Postoperative MPT in patients with RLNP was shorter than that in patients without RLNP; however, it was similar to that in patients with or without AL and RC. LE was not associated with any complications. Patients with an RSST score ≤2 at 2 weeks post-esophagectomy had significant weight loss at 1, 6, and 12 months postoperatively compared with patients with an RSST score ≥3. The proportion of patients with severe weight loss (≥20% weight loss) within 1 year of esophagectomy was significantly greater in patients with RSST scores ≤2 than in those with RSST scores ≥3. Multivariate analysis showed that an RSST score ≤2 was the only predictor of severe post-esophagectomy weight loss. RSST scoring is a simple tool for evaluating post-esophagectomy swallowing function. A lower RSST score is associated with postoperative RLNP, RC, and poor nutritional status.

PMID:38661378 | DOI:10.1093/dote/doae032

Nutritional Status and Quality of Life in Patients with Oral Squamous Cell Carcinoma Before and After Surgical Oncological Treatment: A Single-Center Retrospective Study

Sat, 06 Apr 2024 00:00:00 +0000

Med Sci Monit. 2024 Apr 6;30:e943844. doi: 10.12659/MSM.943844.

ABSTRACT

BACKGROUND Oral squamous cell carcinoma (OSCC) is the most common of head and neck malignancies in well-developed countries. In most cases, patients with OSCC experience a degree of nutritional status disturbances and decreased quality of life (QoL). This study aimed to compare nutritional status and QoL in 51 patients before and after surgery for OSCC. MATERIAL AND METHODS Fifty-one eligible patients with OSCC were followed during a 3-year period (2019-2022). For all patients, we determined body mass index (BMI), serum albumin (ALB), prognostic nutritional index, and nutritional risk index before and after treatment. Also, all patients completed a standardized QoL questionnaire before and after treatment. The obtained data were compared between the groups by using the t test and multivariate Cox regression. RESULTS The values of BMI and NRI were statistically significantly different between the preoperative and postoperative measurements (24.1 kg/m² vs 21.1 kg/m², and 103 vs 100.1, respectively, P=0.001), while values of ALB and prognostic nutritional index did not differ significantly (41.35 g/L vs 39.1 g/L, and 48.5 vs 46.2, respectively). Dysphagia (P=0.03) and chewing problems (P=0.04) were found to be the 2 most important factors decreasing the QoL of patients. CONCLUSIONS Based on our results, BMI and NRI were the most sensitive parameters of nutritional status. Dysphagia and chewing problems were the 2 most important factors affecting the QoL in patients with OSCC.

PMID:38581125 | PMC:PMC11005478 | DOI:10.12659/MSM.943844

Nutrition outcomes and treatment toxicities in patients with head and neck cancer receiving helical intensity‐modulated radiotherapy.

Thu, 01 Feb 2024 05:00:00 +0000

Journal of Human Nutrition & Dietetics; 02/01/2024
(AN 174934213); ISSN: 09523871
CINAHL Complete

Alterations in the oral cavity in patients treated with head and neck radiotherapy: a bibliographic review article.

Mon, 01 Jan 2024 05:00:00 +0000

Salud, Ciencia y Tecnología; 01/01/2024
(AN 181633178); ISSN: 27969711
CINAHL Complete

IMPROVED FUNCTIONAL ORAL INTAKE AND EXERCISE TRAINING ATTENUATE DECLINE IN AEROBIC CAPACITY FOLLOWING CHEMORADIOTHERAPY IN PATIENTS WITH OESOPHAGEAL CANCER.

Mon, 01 Jan 2024 05:00:00 +0000

Journal of Rehabilitation Medicine (Stiftelsen Rehabiliteringsinformation); 01/01/2024
(AN 182282861); ISSN: 16501977
CINAHL Complete

Nutritional Management of Oncological Symptoms: A Comprehensive Review

Sat, 23 Dec 2023 00:00:00 +0000

Nutrients. 2023 Dec 11;15(24):5068. doi: 10.3390/nu15245068.

ABSTRACT

Throughout their experience of illness and during the course of treatment, a substantial proportion of cancer patients are prone to develop nutritional and/or metabolic disturbances. Additionally, cancer patients often encounter long-term side effects from therapies, which may lead to impaired digestion, nutrient absorption or bowel motility. Therefore, the preservation and maintenance of an optimal and balanced nutritional status are pivotal to achieving a better prognosis, increasing the tolerance and adherence to cancer therapies and improving the overall quality of life. In this context, personalized nutritional programs are essential for addressing conditions predisposing to weight loss, feeding difficulties, digestion problems and intestinal irregularity, with the goal of promoting adequate nutrient absorption and minimizing the detrimental effects of treatment regimens. The focus of this research is to examine the most common clinical conditions and metabolic changes that cancer patients may experience, including stomatitis, xerostomia, diarrhea, nausea, vomiting, dysphagia, sub-occlusion, dysgeusia, dysosmia, anorexia, and cachexia. Furthermore, we present a pragmatic example of a multidisciplinary workflow that incorporates customized recipes tailored to individual clinical scenarios, all while maintaining the hedonic value of the meals.

PMID:38140327 | PMC:PMC10745914 | DOI:10.3390/nu15245068

Nutritional Management of Oncological Symptoms: A Comprehensive Review.

Fri, 15 Dec 2023 05:00:00 +0000

Nutrients; 12/15/2023
(AN 174469933); ISSN: 20726643
CINAHL Complete

Nutritional prehabilitation in head and neck cancer: A systematic review of literature

Wed, 06 Dec 2023 00:00:00 +0000

Clin Nutr ESPEN. 2023 Dec;58:326-334. doi: 10.1016/j.clnesp.2023.10.033. Epub 2023 Oct 31.

ABSTRACT

BACKGROUND/SCOPE: Malnutrition is a common problem among patients with head and neck cancer and can have adverse effects on overall health and treatment outcomes. Nutritional and physical prehabilitation are potential strategies to optimize the nutritional status of these patients. This systematic review aimed to identify and describe prehabilitative interventions that can promote an improvement in nutritional status.

METHODS: A systematic review of the literature was conducted in the databases PubMed/Medline, Embase, CINAHL, Scopus and on the platform Web of Science and in Cochrane Library. The selected studies concern adults with head and neck tumours, not malnourished at the time of diagnosis, who undergo nutritional or physical prehabilitation.

RESULTS: Out of 1369 results, 7 studies were included. Multimodal prehabilitation interventions that combine nutritional counseling, oral nutritional supplements, and swallowing exercises to prevent dysphagia have shown positive outcomes in maintaining caloric intake, body weight, swallowing ability, and a reduced incidence of fibrosis in the upper gastrointestinal tract, as well as improving quality of life.

CONCLUSION: Despite the limited number of clinical studies available in the literature, the results suggest that nutritional and physical prehabilitation interventions have a positive effect on the nutritional status and clinical outcomes of patients with head and neck cancer, helping mitigate the risk of malnutrition and improve general well-being.

PMID:38057023 | DOI:10.1016/j.clnesp.2023.10.033

Clinical impact of diarrhea during enteral feeding after esophagectomy

Thu, 23 Nov 2023 00:00:00 +0000

Int J Clin Oncol. 2024 Jan;29(1):36-46. doi: 10.1007/s10147-023-02428-5. Epub 2023 Nov 23.

ABSTRACT

BACKGROUND: Enteral feeding (EF) is recommended to enhance nutritional status after esophagectomy; however, diarrhea is a common complication of EF. We investigated the clinical and prognostic impact of diarrhea during EF after esophagectomy.

METHODS: One hundred and fifty-two patients who underwent transthoracic esophagectomy were enrolled. The King's stool chart was used for stool characterization. The short- and long-term outcomes were compared between a non-diarrhea (Group N) and diarrhea group (Group D).

RESULTS: A higher dysphagia score (≥ 1) was observed more frequently in Group D than in Group N (45.7% vs. 19.8%, p = 0.002). Deterioration of serum total protein, serum albumin, serum cholinesterase, and the prognostic nutritional index after esophagectomy was greater in Group D than in Group N (p = 0.003, 0.004, 0.014, and 0.001, respectively). Patients in Group D had significantly worse overall survival (OS) and recurrence-free survival (RFS) than those in Group N (median survival time (MST): OS, 21.9 vs. 30.6 months, p = 0.001; RFS, 12.4 vs. 27.7 months, p < 0.001). In stratified analysis due to age, although there was no difference in OS with or without diarrhea in young patients (MST: 24.1 months in a diarrhea group vs. 33.6 months in a non-diarrhea group, p = 0.218), patients in a diarrhea group had significantly worse OS than those in a non-diarrhea group in elderly patients (MST: 17.8 months vs. 27.9 months, p < 0.001).

CONCLUSIONS: Diarrhea during EF can put elderly patients at risk of postoperative malnutrition and a poor prognosis after esophagectomy.

PMID:37994975 | PMC:PMC10764458 | DOI:10.1007/s10147-023-02428-5

Cross-sectional observational study: Investigation of zinc concentration in white patients with cancer

Sat, 04 Nov 2023 00:00:00 +0000

Nutrition. 2024 Jan;117:112235. doi: 10.1016/j.nut.2023.112235. Epub 2023 Sep 24.

ABSTRACT

OBJECTIVES: Numerous studies describe the role of zinc in the immune system and metabolism. Zinc may influence the pathogenesis and prognosis of cancer. The aim of this study to determine the prevalence of zinc deficiency in patients with cancer. The study's primary objective was to evaluate the frequency of zinc deficiency in White patients with cancer and characterize the clinical factors predisposing individuals to decreased zinc concentration. The study also aimed to estimate the dose of zinc supplementation that would prevent deficiency.

METHODS: Retrospective data for this cross-sectional study were analyzed from 300 consecutive white patients diagnosed with neoplastic disease and admitted to a major oncology hospital for treatment. Zinc plasma concentration, nutritional status, body composition, and medical history of ailments and dysphagia were recorded. Supplementation was introduced in patients with zinc deficiency according to the local protocol. Zinc plasma levels were collected at follow-up visits.

RESULTS: Zinc deficiency was diagnosed in 68% of the patients. Poor nutritional status was significantly associated with zinc deficiency (low body mass index, weight loss, low albumin level). Low lean body mass (P = 0.003) and adipose tissue (P = 0.045) correlated with zinc deficiency. Patients with zinc deficiency reported dysphagia more frequently than those with normal zinc levels (18 versus 8%; P = 0.03). Squamous cell carcinoma was significantly associated with zinc deficiency (P = 0.043). Oral zinc supplementation resulted in reaching laboratory norms for plasma concentration in only 27% of patients with zinc deficiency and was not dependent on lower (10-15 mg) or higher (25-30 mg) dosing (P > 0.05).

CONCLUSIONS: Zinc deficiency is common in cachectic, malnourished patients with cancer. Nutritional guidelines for these patients should include screening for micronutrient deficiencies. Further studies are needed to determine the role, dosage, duration, and form of nutritional supplementation recommended for specific cancer diagnoses.

PMID:37924623 | DOI:10.1016/j.nut.2023.112235

Predicting the need for prophylactic gastrostomy in major head and neck cancer surgery: The PEG score

Wed, 04 Oct 2023 00:00:00 +0000

Head Neck. 2023 Dec;45(12):3042-3052. doi: 10.1002/hed.27532. Epub 2023 Oct 3.

ABSTRACT

BACKGROUND: To elaborate a preoperative score to predict the necessity of enteral nutrition at 28 days postoperatively in patients undergoing head and neck surgery.

METHODS: A total of 424 patients with oral cavity, oropharyngeal, laryngeal, and hypopharyngeal carcinoma were retrospectively enrolled and analyzed to identify preoperative predictors of prolonged postsurgical enteral feeding which were used to create a prediction model with an easy-to-use nomogram.

RESULTS: Five preoperative variables (body mass index, previous radiotherapy, preoperative dysphagia, type of surgery, flap reconstruction) were found to be independent predictive factors and were used to create a prediction model named PEG score together with the related nomogram. Accuracy, F1, and the area under the curve (AUC) were 0.74, 0.83, and 0.74. Different decision thresholds can be used to vary the sensitivity and specificity.

CONCLUSIONS: The PEG score showed high prediction performances for modeling the need for enteral nutrition at 28 days postoperatively. Prospective studies are needed to define a personalized nutrition protocol.

PMID:37789705 | DOI:10.1002/hed.27532

Managing eating problems after cancer

Sat, 02 Sep 2023 00:00:00 +0000

Maturitas. 2023 Dec;178:107843. doi: 10.1016/j.maturitas.2023.107843. Epub 2023 Aug 27.

ABSTRACT

Cancer treatment can cause food-limiting eating problems that persist or arise months or years after treatment, with negative consequences for the survivor's nutritional status, physical and social function, and quality of life. Hence, post-treatment follow-up and cancer rehabilitation services should aim to support the survivor in managing treatment-related eating problems. This narrative review summarizes the evidence on and provides an overview of interventions to manage eating problems after cancer. Interventions are grouped into four: 1) food-based interventions, including alternating food/fluids and experimenting through the trial-and-error strategy to find tolerated foods; 2) eating behavioral interventions, including instructions on swallowing techniques, posture, and utensils; 3) psychosocial support interventions, including group-based interventions and interventions including relatives; and 4) physical interventions, including exercises to improve dysphagia or trismus. While physical interventions are supported by evidence from several intervention studies, few studies evaluating the effect of other types of interventions in survivors were identified. Instead, qualitative and observational data providing insights on experiences of and coping strategies applied by survivors with eating problems underpin the need for the other types of interventions. Since existing research primarily focuses on survivors of head and neck cancer, future studies on the organization and effects of interventions aimed at managing eating problems among different groups of survivors are relevant.

PMID:37659131 | DOI:10.1016/j.maturitas.2023.107843

Challenges for Assessing Oropharyngeal Dysphagia: The Role of the Eating Assessment Tool-10 (EAT-10).

Tue, 01 Aug 2023 04:00:00 +0000

Journal of Nutrition, Health & Aging; 08/01/2023
(AN 171897835); ISSN: 12797707
CINAHL Complete

Managing the nutritional status of people with oesophagogastric cancer: a literature review.

Sat, 01 Jul 2023 04:00:00 +0000

Cancer Nursing Practice; 07/01/2023
(AN 164655291); ISSN: 14754266
CINAHL Complete

Oropharyngeal dysphagia in head and neck cancer: how to reduce aspiration pneumonia.

Sat, 01 Jul 2023 04:00:00 +0000

Journal of Laryngology & Otology; 07/01/2023
(AN 164916409); ISSN: 00222151
CINAHL Complete

Nutritional Status and the Outcomes of Endoscopic Stenting in Benign and Malignant Diseases of Esophagus

Wed, 29 Mar 2023 00:00:00 +0000

Nutrients. 2023 Mar 21;15(6):1524. doi: 10.3390/nu15061524.

ABSTRACT

BACKGROUND: Endoscopic stenting (ES) is a widely known method for palliative dysphagia treatment in esophageal strictures. Esophageal cancer is often associated with advanced malnutrition, which may increase the risk of complications of the procedure. The aim of this study was to evaluate complication rates and the impact of nutritional status on the outcomes of ES.

PATIENTS AND METHODS: A single-center retrospective study was conducted at Copernicus Hospital in Gdańsk, Poland. Adult patients who underwent endoscopic stenting between February 2014 and December 2018 were included. The influence of patient characteristics (age, sex, indications for esophageal stenting, and location of stenosis) and nutritional status (BMI, NRS 2002, GLIM, and dysphagia score) on complication rates and survival were analyzed.

RESULTS: Eighty-one patients (69% men) were enrolled in the study. In 69%, the indication for ES was malignancy (mainly esophageal cancer). The median dysphagia score significantly decreased from 2.8 to 0.6 after the procedure (p < 0.001). Complications were observed in 27% (n = 22) of the patients. Early complications were bleeding (2.5%), stent unexpansion (2.5%), and stent migration during the procedure (3.7%). There were no early fatal complications of the procedure. Late complications included: stent migration (6.2%), tissue overgrowth (6.2%), food impaction (2.2%), fistula formation (3.7%), bleeding (3.7%), and stent malposition (1.2%). A total of 76% of the participants scored ≥ 3 points in nutritional screening (NRS2002) and 70% were diagnosed with severe malnutrition (GLIM -stage 2). A stent diameter of < 2.2 cm compared with ≥ 2.2 was associated with a higher rate of migrations (15.5% vs. 2.5%). The median survival time in the malignant group was 90 days. Histopathological diagnosis and patients' nutritional status (BMI, NRS 2002, GLIM, and dysphagia score) had no significant effect on complication rates and survival after esophageal stent insertion.

CONCLUSIONS: Endoscopic stenting is a relatively safe procedure for the palliative treatment of esophageal strictures. Severe malnutrition, although common, does not affect the outcomes of the procedure.

PMID:36986253 | PMC:PMC10053737 | DOI:10.3390/nu15061524

Nutritional Status and the Outcomes of Endoscopic Stenting in Benign and Malignant Diseases of Esophagus.

Wed, 15 Mar 2023 04:00:00 +0000

Nutrients; 03/15/2023
(AN 162814432); ISSN: 20726643
CINAHL Complete

Laparogastroscopy—A Transgastric Laparoscopic Approach for Malignant Esophageal Stenosis.

Wed, 15 Mar 2023 04:00:00 +0000

Healthcare (2227-9032); 03/15/2023
(AN 162808359); ISSN: 22279032
CINAHL Complete

Nutrition impact symptoms: Noteworthy prognostic indicators for lung cancer

Thu, 02 Mar 2023 00:00:00 +0000

Clin Nutr. 2023 Apr;42(4):550-558. doi: 10.1016/j.clnu.2023.02.021. Epub 2023 Feb 24.

ABSTRACT

BACKGROUND: Nutrition impact symptoms (NIS) in head and neck cancer are well-studied and are found to be heavy contributors of poor outcome. However, the prevalence and role of NIS in other cancer are less addressed. In this study, we investigated the incidence and prognostic role of NIS in patients with lung cancer.

METHODS: NIS, evaluated by patient-generated subjective global assessment (PG-SGA) in a multicenter real-world prospective study, included loss of appetite, nausea, vomiting, mouth ulcer, constipation, diarrhea, dry mouth, taste change, altered smell, dysphagia, early satiety, and pain. The endpoints were the patients' overall survival (OS) and quality of life (QoL). The COX analysis was used to investigate the relationship between NIS and OS. Interaction analysis and mediation analysis were performed to determine the modifiers and mediator.

RESULTS: 3634 patients with lung cancer were enrolled in this study, of which 1533 patients had NIS. During the average follow-up of 22.65 months, 1875 deaths occurred. The OS of patients with lung cancer with NIS was lower than that of patients without NIS. NIS (HR, 1.181, 95% CI, 1.073-1.748), loss of appetite (HR, 1.266, 95% CI, 1.137-1.409), vomiting (HR, 1.282, 95% CI, 1.053-1.561), and dysphagia (HR, 1.401, 95% CI, 1.079-1.819) were independent prognostic factors in patients with lung cancer. There were interactions between chemotherapy and primary tumor on NIS . In the relationship between different types of NIS (NIS, loss of appetite, vomiting, dysphagia) and prognosis, the mediating effects of inflammation accounted for 15.76%, 16.49%, 26.32%, and 18.13%, respectively. Meanwhile, these three NIS were closely associated with the occurrence of severe malnutrition and cancer cachexia.

CONCLUSIONS: 42% patients with lung cancer experienced different types of NIS. NIS were independent indicators of malnutrition, cancer cachexia and shorter OS, and closely related to QoL. NIS management is of clinical significance.

PMID:36863291 | DOI:10.1016/j.clnu.2023.02.021

Effect of nutritional status before radiotherapy on radiation-induced acute toxicities in patients with nasopharyngeal carcinoma

Thu, 05 Jan 2023 00:00:00 +0000

Head Neck. 2023 Mar;45(3):620-628. doi: 10.1002/hed.27275. Epub 2023 Jan 4.

ABSTRACT

BACKGROUND: To investigate the effect of nutritional status on radiation-induced acute toxicities in nasopharyngeal carcinoma (NPC) patients before radiotherapy.

METHODS: Nutritional status of 228 patients with NPC who received intensity-modulated radiotherapy was retrospectively analyzed by modified nutrition index (m-NI). Cumulative grading score of six common acute toxicities were defined as total score for acute toxicities.

RESULTS: M-NI ≤6 is a risk factor for xerostomia (p = 0.016, OR = 0.208, 95% CI 0.058-0.743), oral mucositis (p = 0.016, OR = 0.287, 95% CI 0.104-0.793), dysgeusia (p = 0.001, OR = 0.028, 95% CI 0.004-0.217), and dysphagia (p = 0.015, OR = 0.251, 95% CI 0.083-0.764) as well in patients with NPC. Total score of radiation-induced acute toxicities of patients with malnutrition (13.6 ± 1.7) was significantly higher than that of patients with normal nutrition (12.0 ± 2.4) (t = -5.464, p < 0.001).

CONCLUSIONS: NPC patients with malnutrition before radiotherapy develop more serious dysgeusia, oral mucositis, dysphagia, and xerostomia after intensity-modulated radiotherapy.

PMID:36600471 | DOI:10.1002/hed.27275

nutrition_dysphagie

Nutrition impact symptoms as prognostic indicators in gastric cancer: the role of quality of life and survival outcomes

Wound Healing in a Glottic Cancer Patient: A Case Report on Nutritional Intervention

L-Carnitine to Reduce Chemoradiotherapy-Induced Toxicity in Head and Neck Cancer: A Randomized Study

Exploration of a remote swallowing training model after laryngeal cancer surgery: Non-randomized concurrent controlled trial

Nutritional outcomes and impact of malnutrition in a randomised comparison between standard and prolonged time to surgery after neoadjuvant chemoradiotherapy for oesophageal cancer

Normalcy of Swallowing in Head and Neck Cancer Patients Undergoing Particle Therapy Supported by Combined Swallowing Training and Feeding Management: A Randomised Controlled Trial.

Analysis of the impact of minimally invasive esophagectomy on quality of life and functional prognosis in patients with esophageal squamous cell carcinoma: A retrospective comparative study

Assessing the Impact of Removable Prosthetic Restorations on Nutritional Habits in Edentulous Patients Following Surgery for Head and Neck Cancer.

Assessing the Impact of Nutritional Status on the Quality of Life in Head and Neck Cancer Patients—The Need for Comprehensive Digital Tools.

Percutaneous Endoscopic Gastrostomy in the 21st Century-An Overview of 1415 Consecutive Dysphagic Adult Patients

Dysphagia, nutritional status, and quality of life in patients with head and neck cancer undergoing radiotherapy alone or combined with chemotherapy: an observational study

Percutaneous Endoscopic Gastrostomy in the 21st Century—An Overview of 1415 Consecutive Dysphagic Adult Patients.

Normalcy of Swallowing in Head and Neck Cancer Patients Undergoing Particle Therapy Supported by Combined Swallowing Training and Feeding Management: A Randomised Controlled Trial

Dysphagia and quality of life in older adults receiving home‐based medical care.

Malnutrition in patients with advanced head and neck cancer: Exploring the Global Leadership Initiative on Malnutrition (GLIM) criteria, energy balance and health-related quality of life

Novel nutrition strategies in gastric and esophageal cancer

Prevalence and Risk Factors of Oropharyngeal Dysphagia in Newly Diagnosed Head-and-Neck Cancer Patients.

叙事心理疗法在喉癌外科治疗后吞咽障碍患者 营养管理中的应用.

Addressing Inflammaging and Disease-Related Malnutrition: Adequacy of Oral Nutritional Supplements in Clinical Care.

Integrative multi-omics and big data analysis of global nutrition and radiotherapy trends

How enteral nutrition modes influence nasopharyngeal carcinoma survivors with late dysphagia after radiotherapy: a randomized controlled study

The Importance of Nutrition in Cancer Care: A Narrative Review

Development of a Dysphagia Pathway Program for Head and Neck Cancer in a Rural Patient Population.

Nutritional care in older adults: are we doing everything? An expert opinion review

Quality of Life and Nutritional Outcomes of Stomach-Preserving Surgery for Early Gastric Cancer: A Secondary Analysis of the SENORITA Randomized Clinical Trial

Assessing Nutritional Status in Gastric Cancer Patients after Total versus Subtotal Gastrectomy: Cross-Sectional Study

Effect of nutrition impact symptoms on oral nutritional supplements energy intake and use days in patients with head and neck cancer: A cross-sectional study

Assessing Nutritional Status in Gastric Cancer Patients after Total versus Subtotal Gastrectomy: Cross-Sectional Study.

Nutritional Prognosis of Patients Submitted to Radiotherapy and Its Implications in Treatment

Nutritional Prognosis of Patients Submitted to Radiotherapy and Its Implications in Treatment.

Association of perioperative oral swallowing function with post-esophagectomy outcomes and nutritional statuses in patients with esophageal cancer

Nutritional Status and Quality of Life in Patients with Oral Squamous Cell Carcinoma Before and After Surgical Oncological Treatment: A Single-Center Retrospective Study

Nutrition outcomes and treatment toxicities in patients with head and neck cancer receiving helical intensity‐modulated radiotherapy.

Alterations in the oral cavity in patients treated with head and neck radiotherapy: a bibliographic review article.

IMPROVED FUNCTIONAL ORAL INTAKE AND EXERCISE TRAINING ATTENUATE DECLINE IN AEROBIC CAPACITY FOLLOWING CHEMORADIOTHERAPY IN PATIENTS WITH OESOPHAGEAL CANCER.

Nutritional Management of Oncological Symptoms: A Comprehensive Review

Nutritional Management of Oncological Symptoms: A Comprehensive Review.

Nutritional prehabilitation in head and neck cancer: A systematic review of literature

Clinical impact of diarrhea during enteral feeding after esophagectomy

Cross-sectional observational study: Investigation of zinc concentration in white patients with cancer

Predicting the need for prophylactic gastrostomy in major head and neck cancer surgery: The PEG score

Managing eating problems after cancer

Challenges for Assessing Oropharyngeal Dysphagia: The Role of the Eating Assessment Tool-10 (EAT-10).

Managing the nutritional status of people with oesophagogastric cancer: a literature review.

Oropharyngeal dysphagia in head and neck cancer: how to reduce aspiration pneumonia.

Nutritional Status and the Outcomes of Endoscopic Stenting in Benign and Malignant Diseases of Esophagus

Nutritional Status and the Outcomes of Endoscopic Stenting in Benign and Malignant Diseases of Esophagus.

Laparogastroscopy—A Transgastric Laparoscopic Approach for Malignant Esophageal Stenosis.

Nutrition impact symptoms: Noteworthy prognostic indicators for lung cancer

Effect of nutritional status before radiotherapy on radiation-induced acute toxicities in patients with nasopharyngeal carcinoma

叙事心理疗法在喉癌外科治疗后吞咽障碍患者营养管理中的应用.