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Fourati N, Trigui R, Dhouib F, Nouri O, Siala W, Khanfir A, Mnejja W, Daoud J. Quality of weight loss during chemoradioherapy in patients with nasopharyngeal cancers. Cancer Radiother 2023:S1278-3218(23)00060-4. [PMID: 37095056 DOI: 10.1016/j.canrad.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/15/2022] [Accepted: 12/28/2022] [Indexed: 04/26/2023]
Abstract
PURPOSE Radiation therapy with chemotherapy (CCR) is currently the gold standard treatment for nasopharyngeal carcinoma (NPC). Anatomical changes are mainly due to weight loss. Our prospective study aimed to evaluate the nutritional status and the quality of weight loss in our patients to adapt the subsequent nutritional management of patients during treatment for NPC. PATIENTS AND METHODS A prospective, single-center study of 27 patients with non-metastatic NPC treated in our oncology radiotherapy department between August 2020 and March 2021. Data from interrogation, physical examination, and bioelectrical impedancemetry (weight [W], body mass index [BMI], fat index [GI], fat mass [FM], and fat-free mass (FFM]) were collected at the beginning, the mid, and the end of treatment. RESULTS Weight loss from mid to end of treatment (median=-4kg [-9.4; -0.9]) was greater than that from baseline to mid-treatment (median=-2.9kg [-8.8; 1.8]) (P=0.016). Weight loss during the entire treatment was -6.2kg [-15.6; -2.5] (8.4%). The losses of FM were identical between the beginning-mid treatment and the mid-end treatment; they were respectively -1.4kg [-8.5; 4.2] and -1.4kg [-8.2; 7.8] (P=0.4). FFM losses between the mid- and the end of treatment (-2.5kg [-27.8; 0.5]) were greater than those between baseline and mid-treatment (-1.1kg [-7.1; 4.7]) (P=0.014). Median FFM loss during treatment was -3.6kg [-28.1; 2.6]). CONCLUSION The results of our study show that weight loss during CCR for NPC is complex and is not just about loss but about a disruption of body composition. Regular follow-ups by nutritionists are required to prevent denutrition during treatment.
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Affiliation(s)
- N Fourati
- Service de radiothérapie carcinologique, faculté de médecine, CHU de Habib-Bourguiba, université de Sfax, Sfax, Tunisia.
| | - R Trigui
- Service de radiothérapie carcinologique, faculté de médecine, CHU de Habib-Bourguiba, université de Sfax, Sfax, Tunisia
| | - F Dhouib
- Service de radiothérapie carcinologique, faculté de médecine, CHU de Habib-Bourguiba, université de Sfax, Sfax, Tunisia
| | - O Nouri
- Service de radiothérapie carcinologique, faculté de médecine, CHU de Habib-Bourguiba, université de Sfax, Sfax, Tunisia
| | - W Siala
- Service de radiothérapie carcinologique, faculté de médecine, CHU de Habib-Bourguiba, université de Sfax, Sfax, Tunisia
| | - A Khanfir
- Service d'oncologie médicale, faculté de médecine, CHU de Habib-Bourguiba, université de Sfax, Sfax, Tunisia
| | - W Mnejja
- Service de radiothérapie carcinologique, faculté de médecine, CHU de Habib-Bourguiba, université de Sfax, Sfax, Tunisia
| | - J Daoud
- Service de radiothérapie carcinologique, faculté de médecine, CHU de Habib-Bourguiba, université de Sfax, Sfax, Tunisia
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Prediagnosis weight loss, a stronger factor than BMI, to predict survival in patients with lung cancer. Lung Cancer 2018; 126:55-63. [DOI: 10.1016/j.lungcan.2018.07.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 11/20/2022]
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Guerdoux-Ninot E, Flori N, Janiszewski C, Vaillé A, de Forges H, Raynard B, Baracos VE, Thezenas S, Senesse P. Assessing dietary intake in accordance with guidelines: Useful correlations with an ingesta-Verbal/Visual Analogue Scale in medical oncology patients. Clin Nutr 2018; 38:1927-1935. [PMID: 30355527 DOI: 10.1016/j.clnu.2018.06.974] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 05/16/2018] [Accepted: 06/19/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIMS Energy intake and food ingesta are central in nutritional screening and assessment. Cancer patients are at nutritional risk of losing weight, and clinicians need quick and easy tools to identify patients for nutritional support. This study aimed to evaluate the feasibility and the accuracy of a Visual/Verbal Analogue Scale of food ingesta (ingesta-VVAS) to assess energy food intake and nutritional risk in medical oncology patients. METHODS Dieticians administered prospectively the ingesta-VVAS in 1762 medical oncology patients. The external validity of the ingesta-VVAS was determined against daily energy intake based on a 24-h dietary recall. Patients had to estimate how they currently ate on a scale from 0 "nothing at all" to 10 "as usual". Area Under the Receiver-Operating Characteristics (ROC) curve served as determine the optimal cut-off and provide the discriminative power of the tool to detect patients who ingested less or more than 25 kcal kg-1 day-1. RESULTS The feasibility of the ingesta-VVAS was 97.7%. The scores were significantly correlated with energy intake (ρ = .67, p < .05), whatever the specific situation (i.e. malnutrition or not). With a cut-off of ≤7, the ingesta-VVAS exhibited a good power discrimination (AUC = .804) to detect patients who ingested less or more than 25 kcal kg-1 day-1, with a sensitivity of 80.8%, a positive predictive value of 83.6%, a specificity of 67.5%, and a negative predictive value of 63.3%. Patients with a score ≤7 on the ingesta-VVAS score were at 12-fold higher probability of nutritional risk [OR 12.3; 95% CI (8.7-17.4); p < .001]. Sensitivity to detect patients with a significant weight loss was 71%, and a positive predictive value of 75.9%. CONCLUSIONS This easy-to-use ingesta-VVAS is well-correlated with energy intake and may be useful in clinical practice. An ingesta-VVAS score is ≤ 7 could be used to detect patients with nutritional risk of weight loss in medical oncology.
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Affiliation(s)
- Estelle Guerdoux-Ninot
- Department of Supportive Care, Cancer Institute of Montpellier (ICM), Montpellier, University of Montpellier, France; Department of Clinical Nutrition and Gastroenterology, Cancer Institute of Montpellier (ICM), University of Montpellier, France.
| | - Nicolas Flori
- Department of Clinical Nutrition and Gastroenterology, Cancer Institute of Montpellier (ICM), University of Montpellier, France
| | - Chloé Janiszewski
- Department of Clinical Nutrition and Gastroenterology, Cancer Institute of Montpellier (ICM), University of Montpellier, France
| | - Arnaud Vaillé
- Department of Clinical Nutrition and Gastroenterology, Cancer Institute of Montpellier (ICM), University of Montpellier, France
| | - Hélène de Forges
- Clinical Research Department, Cancer Institute of Montpellier (ICM), University of Montpellier, France
| | - Bruno Raynard
- Department of Supportive Care, Gustave Roussy Cancer Campus, Villejuif, France
| | | | - Simon Thezenas
- Department of Biostatistics, Cancer Institute of Montpellier (ICM), University of Montpellier, France
| | - Pierre Senesse
- Department of Supportive Care, Cancer Institute of Montpellier (ICM), Montpellier, University of Montpellier, France; Department of Clinical Nutrition and Gastroenterology, Cancer Institute of Montpellier (ICM), University of Montpellier, France
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Kaderbay A, Atallah I, Fontaine E, Chobert-Bakouline M, Schmitt S, Mitariu P, Righini CA. Malnutrition and refeeding syndrome prevention in head and neck cancer patients: from theory to clinical application. Eur Arch Otorhinolaryngol 2018; 275:1049-1058. [PMID: 29569135 DOI: 10.1007/s00405-018-4935-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/13/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE The goal of this review is to raise awareness about refeeding syndrome (RFS) and to give a comprehensive presentation of recent guidelines and latest scientific data about nutritional management among head and neck cancer (HNC) patients while focusing on RFS prevention. METHODS A review of literature for nutritional assessment and RFS management was conducted. Electronic searches of Medline, Cochrane, PubMed and Embase databases for articles published in peer-reviewed journals were conducted from February to September 2017 using the keywords: "nutrition assessment", "head and neck cancer", "refeeding syndrome" and "guidelines". Articles, reviews, book references as well as national and international guidelines in English and French were included. RESULTS The prevalence of malnutrition is high in HNC patients and a large number of them will need artificial nutritional support or refeeding intervention. RFS is characterized by fluid and electrolyte imbalance associated with clinical manifestations induced by rapid refeeding after a period of malnutrition or starvation. Regarding risk factors for malnutrition and RFS, HNC patients are particularly vulnerable. However, RFS remains unrecognized among head and neck surgeons and medical teams. Practical data are summarized to help organizing nutritional assessment and refeeding interventions. It also summarizes preventive measures to reduce RFS incidence and morbidity in HNC population. CONCLUSION Nutritional assessment and early refeeding interventions are crucial for HNC patients care. As prevention is the key for RFS management, early identification of patients with high risks is crucial and successful nutritional management requires a multidisciplinary approach.
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Affiliation(s)
- Akil Kaderbay
- Otolaryngology Department, Grenoble Alpes University Hospital, Grenoble, France.
- Grenoble Alpes University, Grenoble, France.
- UGA/Inserm U1205, Braintech Lab, Grenoble, France.
- Otolaryngoloy Department of Grenoble Alpes University Hospital, Hôpital Nord Michallon, CS 10217, 38043, Grenoble Cedex 9, France.
| | - Ihab Atallah
- Otolaryngology Department, Grenoble Alpes University Hospital, Grenoble, France
- Grenoble Alpes University, Grenoble, France
- UGA/UMR/CNRS 5309/Inserm 1209, Institut Albert Bonniot, Grenoble, France
- Otolaryngoloy Department of Grenoble Alpes University Hospital, Hôpital Nord Michallon, CS 10217, 38043, Grenoble Cedex 9, France
| | - Eric Fontaine
- Nutrition Department, Grenoble Alpes University Hospital, Grenoble, France
- UGA/Inserm U1055, Grenoble, France
| | | | - Stephanie Schmitt
- Otolaryngology Department, Grenoble Alpes University Hospital, Grenoble, France
| | | | - Christian Adrien Righini
- Otolaryngology Department, Grenoble Alpes University Hospital, Grenoble, France
- Grenoble Alpes University, Grenoble, France
- UGA/UMR/CNRS 5309/Inserm 1209, Institut Albert Bonniot, Grenoble, France
- Otolaryngoloy Department of Grenoble Alpes University Hospital, Hôpital Nord Michallon, CS 10217, 38043, Grenoble Cedex 9, France
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Flori N, Lecornu H, Arnac S, Clavie B, Fallières A, Francioni L, Vaille A, Georges G, Lacroix C, Senesse P. Cancer chez le sujet obèse : impact sur la survie et sur la prise en charge oncologique. NUTR CLIN METAB 2017. [DOI: 10.1016/j.nupar.2017.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Senesse P, Isambert A, Janiszewski C, Fiore S, Flori N, Poujol S, Arroyo E, Courraud J, Guillaumon V, Mathieu-Daudé H, Colasse S, Baracos V, de Forges H, Thezenas S. Management of Cancer Cachexia and Guidelines Implementation in a Comprehensive Cancer Center: A Physician-Led Cancer Nutrition Program Adapted to the Practices of a Country. J Pain Symptom Manage 2017; 54:387-393.e3. [PMID: 28778558 DOI: 10.1016/j.jpainsymman.2017.01.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 01/13/2023]
Abstract
CONTEXT Cancer-associated cachexia is correlated with survival, side-effects, and alteration of the patients' well-being. OBJECTIVES We implemented an institution-wide multidisciplinary supportive care team, a Cancer Nutrition Program (CNP), to screen and manage cachexia in accordance with the guidelines and evaluated the impact of this new organization on nutritional care and funding. METHODS We estimated the workload associated with nutrition assessment and cachexia-related interventions and audited our clinical practice. We then planned, implemented, and evaluated the CNP, focusing on cachexia. RESULTS The audit showed a 70% prevalence of unscreened cachexia. Parenteral nutrition was prescribed to patients who did not meet the guideline criteria in 65% cases. From January 2009 to December 2011, the CNP team screened 3078 inpatients. The screened/total inpatient visits ratio was 87%, 80%, and 77% in 2009, 2010, and 2011, respectively. Cachexia was reported in 74.5% (n = 2253) patients, of which 94.4% (n = 1891) required dietary counseling. Over three years, the number of patients with artificial nutrition significantly decreased by 57.3% (P < 0.001), and the qualitative inpatients enteral/parenteral ratio significantly increased: 0.41 in 2009, 0.74 in 2010, and 1.52 in 2011. Between 2009 and 2011, the CNP costs decreased significantly for inpatients nutritional care from 528,895€ to 242,272€, thus financing the nutritional team (182,520€ per year). CONCLUSION Our results highlight the great benefits of implementing nutritional guidelines through a physician-led multidisciplinary team in charge of nutritional care in a comprehensive cancer center.
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Affiliation(s)
- Pierre Senesse
- Department of Clinical Nutrition and Gastroenterology, Institut régional du Cancer de Montpellier (ICM), Montpellier, France; Epsylon, EA 4556 Dynamics of Human Abilities and Health Behaviors, University of Montpellier, Montpellier, France.
| | - Agnès Isambert
- Epsylon, EA 4556 Dynamics of Human Abilities and Health Behaviors, University of Montpellier, Montpellier, France
| | - Chloé Janiszewski
- Clinical Research Department, Institut régional du Cancer de Montpellier (ICM), Montpellier, France
| | - Stéphanie Fiore
- Department of Clinical Nutrition and Gastroenterology, Institut régional du Cancer de Montpellier (ICM), Montpellier, France
| | - Nicolas Flori
- Department of Clinical Nutrition and Gastroenterology, Institut régional du Cancer de Montpellier (ICM), Montpellier, France
| | - Sylvain Poujol
- Department of Pharmacy, Institut régional du Cancer de Montpellier (ICM), Montpellier, France
| | - Eric Arroyo
- Computer Information Organisation, Institut régional du Cancer de Montpellier (ICM), Montpellier, France
| | - Julie Courraud
- Clinical Research Department, Institut régional du Cancer de Montpellier (ICM), Montpellier, France
| | - Vanessa Guillaumon
- SIRIC Montpellier Cancer, Institut régional du Cancer de Montpellier (ICM), Montpellier, France
| | - Hélène Mathieu-Daudé
- Medical Information Department, Institut régional du Cancer de Montpellier (ICM), Montpellier, France
| | - Sophie Colasse
- Financial Affairs, Institut régional du Cancer de Montpellier (ICM), Montpellier, France
| | - Vickie Baracos
- Department of Oncology, University of Alberta, Edmonton, Canada
| | - Hélène de Forges
- Clinical Research Department, Institut régional du Cancer de Montpellier (ICM), Montpellier, France
| | - Simon Thezenas
- Biometrics Unit, Institut régional du Cancer de Montpellier (ICM), Montpellier, France
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Bachmann P, Bertrand A, Roux P. Prise en charge nutritionnelle dans les parcours de soins des cancers. NUTR CLIN METAB 2016. [DOI: 10.1016/j.nupar.2016.10.124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Prise en charge nutritionnelle des patients hospitalisés pour allogreffe de CSH : recommandations de la Société francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC). Bull Cancer 2016; 103:S201-S206. [DOI: 10.1016/j.bulcan.2016.09.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 09/07/2016] [Indexed: 11/23/2022]
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Pazart L, Cretin E, Grodard G, Cornet C, Mathieu-Nicot F, Bonnetain F, Mercier M, Cuynet P, Bouleuc C, Aubry R. Parenteral nutrition at the palliative phase of advanced cancer: the ALIM-K study protocol for a randomized controlled trial. Trials 2014; 15:370. [PMID: 25248371 PMCID: PMC4247729 DOI: 10.1186/1745-6215-15-370] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 09/09/2014] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Malnutrition is a common complication in patients at the palliative stage of cancer. During the curative phase of cancer, optimal enteral or parenteral nutrition intake can reduce morbidity and mortality, and improve quality of life. When the main goal of treatment becomes palliative, introduction of artificial nutrition is controversial. Although scientific societies do not recommend the introduction of artificial nutrition in all cases of malnutrition, especially in hypophagic patients if their life expectancy is shorter than 2 months, considerable differences in the use of parenteral nutrition in nonsurgical oncology practice are noted around the world. One explanation is a paucity of well-conducted randomized controlled trials in these situations, and consequently, the risk/benefit ratio of parenteral nutrition and its impact on quality of life in palliative care remains uncertain. METHODS/DESIGN The ALIM-K study is a French national multicenter randomized controlled trial designed to evaluate the effectiveness of parenteral nutrition, versus an exclusive oral-feeding supply, on the quality of life of malnourished patients who have a functional digestive tube and who are at the palliative phase of advanced cancer with a life expectancy of more than 2 months. DISCUSSION This article presents the methodologic options chosen for our study, and in particular, the choice of the Zelen method of randomization, the definition of the main end point (quality of life), the choice of comparator (oral feeding), and the inclusion criteria (life expectancy of more than 2 months), which are all critical points in building a randomized controlled trial in the setting of palliative care. TRIAL REGISTRATION This study was registered with the clinical trials database ClinicalTrials.gov on May 27, 2014, under the number NCT02151214.
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Affiliation(s)
- Lionel Pazart
- />Inserm CIC 1431, CHRU de Besançon, Besançon, France
| | - Elodie Cretin
- />Inserm CIC 1431, CHRU de Besançon, Besançon, France
- />Département douleur – Soins palliatifs, CHRU de Besançon, Besançon, France
- />Espace Ethique Bourgogne Franche-Comté, Franche-Comté, France
- />Laboratoire Logiques de l’Agir EA 2274, Université de Franche-Comté, Besançon, France
| | | | - Cecile Cornet
- />Inserm CIC 1431, CHRU de Besançon, Besançon, France
- />Département douleur – Soins palliatifs, CHRU de Besançon, Besançon, France
- />Espace Ethique Bourgogne Franche-Comté, Franche-Comté, France
| | - Florence Mathieu-Nicot
- />Inserm CIC 1431, CHRU de Besançon, Besançon, France
- />Département douleur – Soins palliatifs, CHRU de Besançon, Besançon, France
- />Espace Ethique Bourgogne Franche-Comté, Franche-Comté, France
- />Laboratoire EA 3188 de psychologie de Besançon, Université de Franche-Comté, Besançon, France
| | - Franck Bonnetain
- />Plateforme « Qualité de vie et cancer », Besançon, France
- />EA 3181, Université de Franche-Comté, Franche-Comté, France
| | - Mariette Mercier
- />Plateforme « Qualité de vie et cancer », Besançon, France
- />EA 3181, Université de Franche-Comté, Franche-Comté, France
| | - Patrice Cuynet
- />Laboratoire EA 3188 de psychologie de Besançon, Université de Franche-Comté, Besançon, France
| | - Carole Bouleuc
- />Département de soins de support et de soins palliatifs, Institut Curie, Paris, France
| | - Regis Aubry
- />Inserm CIC 1431, CHRU de Besançon, Besançon, France
- />Département douleur – Soins palliatifs, CHRU de Besançon, Besançon, France
- />Espace Ethique Bourgogne Franche-Comté, Franche-Comté, France
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Bachmann P, Bensadoun RJ, Besnard I, Bourdel-Marchasson I, Bouteloup C, Crenn P, Goldwasser F, Guérin O, Latino-Martel P, Meuric J, May-Lévin F, Michallet M, Vasson MP, Hébuterne X. Clinical nutrition guidelines of the French Speaking Society of Clinical Nutrition and Metabolism (SFNEP): Summary of recommendations for adults undergoing non-surgical anticancer treatment. Dig Liver Dis 2014; 46:667-74. [PMID: 24794790 DOI: 10.1016/j.dld.2014.01.160] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 01/28/2014] [Indexed: 12/11/2022]
Abstract
Up to 50% of patients with cancer suffer from weight loss and undernutrition (as called cachexia) even though it is rarely screened or properly handled. Patients' prognosis and quality of life could be greatly improved by simple and inexpensive means encompassing nutritional status assessment and effective nutritional care. These guidelines aim to give health professionals and patients practical and up-to-date advice to manage nutrition in the principal situations encountered during the cancer course according to the type of tumour and treatment (i.e. radio and/or chemotherapy). Specific suggestions are made for palliative and elderly patients because of specific risks of undernutrition and related comorbidities in this subset. Levels of evidence and grades of recommendations are detailed as stated by current literature and consensus opinion of clinical experts in each field.
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Prevost V, Joubert C, Heutte N, Babin E. Assessment of nutritional status and quality of life in patients treated for head and neck cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2014; 131:113-20. [PMID: 24657191 DOI: 10.1016/j.anorl.2013.06.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 06/25/2013] [Indexed: 12/13/2022]
Abstract
The purpose of this study was to identify tools for the assessment of nutritional status in head and neck cancer patients, to evaluate the impact of malnutrition on therapeutic management and quality of life and to propose a simple screening approach adapted to routine clinical practice. The authors conducted a review of the literature to identify tools for the assessment of nutritional status in head and neck cancer patients published in French and English. Articles were obtained from the PubMed database and from the references of these articles and selected journals, using the keywords: "nutritional assessment", and "head and neck" and "cancer". Anthropometric indices, laboratory parameters, dietary intake assessment, clinical scores and nutritional risk scores used in patients with head and neck cancers are presented. The relevance of these tools in clinical practice and in research is discussed, together with the links between nutritional status and quality of life. This article is designed to help teams involved in the management of patients with head and neck cancer to choose the most appropriate tools for assessment of nutritional status according to their resources and their objectives.
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Affiliation(s)
- V Prevost
- Inserm U1086, Cancers et Préventions, avenue de la Côte-de-Nacre, 14000 Caen, France; Université de Caen Basse-Normandie EA 3936, Esplanade de la Paix, BP 5186, 14032 Caen cedex 05, France; Centre Régional de Lutte contre le Cancer François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France.
| | - C Joubert
- Unité Transversale de Nutrition Clinique, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - N Heutte
- Inserm U1086, Cancers et Préventions, avenue de la Côte-de-Nacre, 14000 Caen, France; Université de Caen Basse-Normandie EA 3936, Esplanade de la Paix, BP 5186, 14032 Caen cedex 05, France; Centre Régional de Lutte contre le Cancer François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - E Babin
- Inserm U1086, Cancers et Préventions, avenue de la Côte-de-Nacre, 14000 Caen, France; Service ORL et Chirurgie Cervico-Faciale, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France; CERReV EA3918, Esplanade de la Paix, 14000 Caen, France
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Flori N, Chrostek H, Bianchi L, Assenat É, Fallières A, Vaille A, Bouteloup C, Senesse P. Prise en charge d’un patient atteint d’un cancer des voies aéro-digestives supérieures. NUTR CLIN METAB 2013. [DOI: 10.1016/j.nupar.2013.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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