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Viana Veloso GG, Amaral FD, Nogueira-Rodrigues A. Impact of COVID-19 pandemic among patients with lung and head and neck cancer assisted in a public cancer center in Brazil. BMC Cancer 2024; 24:539. [PMID: 38679710 PMCID: PMC11057144 DOI: 10.1186/s12885-024-12255-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/11/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND There is no updated national data regarding the real impact of the COVID-19 pandemic on delaying diagnosis and treatment among patients with lung, and head, and neck cancers in Brazil. This study aimed to analyze the COVID-19 pandemic impact on cancer diagnosis and clinical outcomes among lung, head, and neck cancer patients assisted in a tertiary cancer center in Southeastern Brazil, as well as to analyze these patients' pretreatment clinical features. METHODS Retrospective cohort of patients with lung or head and neck cancer assisted in a tertiary cancer center in southeastern Brazil between January/2019 and December/2021. To assess statistical differences among groups [i.e., cohort 2019 versus (vs.) 2020 and 2019 vs. 2021] chi-square test was used with a 5% significance level and 90% power for sample size calculation. Differences among baseline clinical features and sociodemographic characteristics were evaluated either by T-test for two samples or Fisher's or Pearson's chi-square test (for quantitative or qualitative variables). All utilized tests had a 5% significance level. RESULTS Six hundred fifty-two patients were included, 332 with lung and 320 with head and neck cancer; it was observed a significant decrease in oncologic treatment recommendations and increase in palliative care recommendation for patients with lung cancer, despite similar stages at diagnosis. During the COVID-19 pandemic, more pain symptoms were reported at the first Oncology assessment for patients with head and neck cancer (p < 0.05). Compared to 2019, head and neck cancer patients diagnosed in 2021 presented a worse initial performance status (p = 0.008). There was a statistically significant increase in survival for patients diagnosed with head and neck cancer in 2021 when compared to 2019 (p = 0.003). CONCLUSIONS This research highlights low survival rates for patients with lung and head and neck cancer in Brazil, even before the pandemic started, as consequence of advanced diseases at diagnosis at the public health system and clinical degrading features. Additionally, there was an increase incidence in both lung cancer and head and neck cancer despite no differences in clinical stage. This reflects how fragile is the public healthcare system even before facing an acute public health crisis such as the COVID-19 pandemic. Yet, the total impact on public health may follow for many years.
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Affiliation(s)
- Gilson Gabriel Viana Veloso
- MD, Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de, Minas Gerais - FCM-MG, Oncologist, Oncoclínicas&Co/MedSir, Belo Horizonte, MG, Brazil
| | | | - Angélica Nogueira-Rodrigues
- Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais - FCM-MG, Federal University of Minas Gerais - UFMG, Brazilian Group of Gynecologic Oncology (EVA), Oncoclínicas&Co/MedSir, DOM Oncologia, Belo Horizonte, MG, Brazil.
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Rasteniene R, Simenaite G, Zaleckas L, Aleksejuniene J. Non-odontogenic maxillofacial infections - a 17-years retrospective cohort study. Oral Maxillofac Surg 2024; 28:425-434. [PMID: 37289303 DOI: 10.1007/s10006-023-01162-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/02/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE A retrospective 17-year review of the epidemiology, microbiological aspects, and treatment of patients hospitalized for non-odontogenic maxillofacial infections. METHODS A retrospective study reviewed 4040 medical records of patients hospitalized at Vilnius University Hospital Zalgiris Clinic during the period of 2003 to 2019. The following data were collected: patient sociodemographic characteristics, length of hospitalization, sources of infection, affected anatomical regions, treatment modalities, microbiological findings, and sensitivity to antibiotics. RESULTS The mean (sd) annual incidence of non-odontogenic maxillofacial infections over the past 17 years was 237 (49) cases, and the mean (sd) hospital stay was 7.3 (4.5) days. The male-to-female ratio was 1.9:1, while the mean (sd) patient age was 42.1 (19.0) years. The need for an additional incision and the involvement of multiple anatomical regions were the strongest predictors of longer hospitalization. A total of 139 microorganism species were identified, with Bacteroides, Prevotella, and Staphylococcus showing the highest resistance to penicillin. CONCLUSIONS Longer hospital stays were associated with older age (≥ 65 years), smoking, systemic diseases, type of treatment, involvement of multiple anatomical regions, and the need for additional surgery. Most of the cultured microorganisms were Staphylococcus species.
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Affiliation(s)
- Ruta Rasteniene
- Institute of Odontology, Faculty of Medicine, University of Vilnius, Žalgirio Str. 117, 08217, Vilnius, Lithuania.
| | - Gabriele Simenaite
- Institute of Odontology, Faculty of Medicine, University of Vilnius, Žalgirio Str. 117, 08217, Vilnius, Lithuania
| | - Linas Zaleckas
- Institute of Odontology, Faculty of Medicine, University of Vilnius, Žalgirio Str. 117, 08217, Vilnius, Lithuania
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Krzywon A, Kotylak A, Cortez AJ, Mrochem-Kwarciak J, Składowski K, Rutkowski T. Influence of nutritional counseling on treatment results in patients with head and neck cancers. Nutrition 2023; 116:112187. [PMID: 37683314 DOI: 10.1016/j.nut.2023.112187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/28/2023] [Accepted: 08/05/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVES Nutritional intervention, including nutritional counseling (NC), plays a significant role in the comprehensive management of patients with head and neck cancer (HNC). The aim of this study was to investigate the effects of NC combined with oral nutritional supplements during radical treatment on weight loss and survival outcomes in patients with HNC. METHODS The study included 310 patients who received radical treatment for HNC. Among these patients, 119 underwent NC along with oral nutritional supplements (NCONS); 191 were supported with oral nutritional supplements only (ONS). The study aimed to investigate the effects of sex, disease stage, treatment modality, and tumor site on weight loss. Additionally, the Kaplan-Meier method assessed the influence of NC on overall survival and disease-free survival. RESULTS The present study suggested that the NC independently prevented weight loss, regardless of sex and disease stage (female: -1.6%, P = 0.001; male: -2.3 %, P = 0.003; T stage (0-2): -1.7%, P = 0.008; T stage (3-4): -2.7%, P = 0.003; N stage (0-1): 2.5%, P = 0,027; N stage (3-4): 2.9%, P < 0.001). The protective effect was most significant in patients with oral cancer and oropharyngeal cancer and in patients treated with chemotherapy (oral: -1.7%, P = 0.03; oropharynx: -3.3%, P < 0.001; radiochemotherapy: -3%, P = 0.028; induction chemotherapy preceded radiochemotherapy: -6%, P < 0.001). Furthermore, the 3-year overall survival rates were 93.4% and 85.4% in the NC along with oral nutritional supplements (NCONS) and oral nutritional supplement (ONS) groups, respectively (P = 0.031). CONCLUSIONS Patients with HNC who received NC during radical treatment experienced reduced weight loss. This effect was particularly pronounced in patients with oral cavity or oropharyngeal cancer and those undergoing chemotherapy. Additionally, NC was associated with improved overall survival in this patient cohort. Nevertheless, further studies are required to validate and support these findings.
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Affiliation(s)
- Aleksandra Krzywon
- Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland.
| | - Anna Kotylak
- I Radiation and Clinical Oncology Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Alexander Jorge Cortez
- Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Jolanta Mrochem-Kwarciak
- Analytics and Clinical Biochemistry Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Krzysztof Składowski
- I Radiation and Clinical Oncology Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Tomasz Rutkowski
- Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland.
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Wang G, Ou M, Chen H, Zhu S, Chen Y, Xu X. Perioperative nutritional risk and its influencing factors in patients with oral cancer: a longitudinal study. Front Nutr 2023; 10:1200820. [PMID: 37426177 PMCID: PMC10327895 DOI: 10.3389/fnut.2023.1200820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/09/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction We aimed to investigate the nutritional risk status and dynamic changes in patients with perioperative oral cancer at different stages and analyze the factors influencing nutritional risk and the correlation among body mass index, nutrition-related symptoms, and nutritional risk. Methods In total, 198 patients with oral cancer who were hospitalized in the Head & Neck Surgery Departments of a tertiary cancer hospital in Hunan Province, China, from May 2020 to January 2021, were selected as participants. The Nutritional Risk Screening 2002 scale and Head and Neck Patient Symptom Checklist were used to assess patients on admission day, 7 days post-surgery, and 1 month post-discharge. Multivariate analysis of variance, paired t-test, and generalized estimating equation were used to analyze the trajectory and influencing factors of nutritional risk in patients with perioperative oral cancer. Spearman's correlation analysis was used to explore the correlation among body mass index, symptoms, and nutritional risk. Results The nutritional risk scores of patients with oral cancer at the three time points were 2.30 ± 0.84, 3.21 ± 0.94, and 2.11 ± 0.84, respectively, and the differences were significant (p < 0.05). The incidences of nutritional risk were 30.3, 52.5, and 37.9%, respectively. The factors influencing nutritional risk included education level, smoking status, clinical stage, flap repair, and tracheotomy (β = -0.326, 0.386, 0.387, 0.336, and 0.240, respectively, p < 0.05). Nutritional risk was negatively correlated with body mass index (rs = -0.455, p < 0.01) and positively correlated with pain, loss of appetite, sore mouth, bothersome smells, swallowing difficulty, taste changes, depression, chewing difficulty, thick saliva, and anxiety (rs = 0.252, 0.179, 0.269, 0.155, 0.252, 0.212, 0.244, 0.384, 0.260, and 0.157, respectively, p < 0.05). Conclusion The incidence of nutritional risk in patients with perioperative oral cancer was high, and the trajectory of nutritional risk changed over time. Strengthening the nutritional monitoring and management of postoperative patients or those with low education level, advanced-stage cancer, flap repair, tracheotomy, and low body mass index; strengthening tobacco control management; and controlling nutrition-related discomfort symptoms in perioperative oral cancer patients are necessary.
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Affiliation(s)
- Guifen Wang
- Department of Gynecology, The Third Xiangya Hospital, Central South University, Changsha, China
- Department of Nursing, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Meijun Ou
- Department of Head and Neck Surgery, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Hong Chen
- Department of Head and Neck Surgery, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Shujuan Zhu
- Department of Gynecology, The Third Xiangya Hospital, Central South University, Changsha, China
- Department of Nursing, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yongyi Chen
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Xianghua Xu
- Health Service Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
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Fuhse K. [Weight, nutrition, quality of life-Perspective of oncological patients]. INNERE MEDIZIN (HEIDELBERG, GERMANY) 2023:10.1007/s00108-023-01528-8. [PMID: 37221380 DOI: 10.1007/s00108-023-01528-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 05/25/2023]
Abstract
Nutrition is associated with pleasure and quality of life. The majority of oncological patients experience tumor-associated and treatment-associated nutrition-related symptoms and malnutrition. Consequently, the perception of nutrition during the course of the disease is increasingly more characterized by negative associations, which may persist for years after the end of treatment. This leads to a decreased quality of life, social isolation and a burden for relatives. In contrast, weight loss is initially positively perceived, especially by patients who previously perceived themselves as being overweight, until malnutrition becomes evident and leads to a decreased quality of life. Nutritional counseling can prevent weight loss, relieve adverse side effects, improve the quality of life and reduce mortality. Patients are not aware of this and the German healthcare system lacks structured and firmly established access pathways to nutritional counseling. Therefore, oncological patients need to be informed about the consequences of weight loss at an early stage and low-threshold access to nutritional counseling needs to be comprehensively implemented. Thus, malnutrition can be recognized and treated at an early stage and nutrition can contribute to a higher quality of life as a positively perceived daily activity.
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Affiliation(s)
- Katrin Fuhse
- Klinikum Bremen Mitte, Medizinische Klinik II, St.-Jürgen-Str. 1, 28205, Bremen, Deutschland.
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Li W, Yang Y, Li Z, Chen W. Effect of malnutrition and nutritional support to reduce infections in elderly hospitalized patients with cancer: A multicenter survey in China. Nutrition 2023; 106:111894. [PMID: 36459844 DOI: 10.1016/j.nut.2022.111894] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/11/2022] [Accepted: 10/26/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Malnutrition is common among elderly patients with cancer, and greatly affects patients' quality of life. Malnutrition is a key factor in the development of systemic, chronic, low-grade inflammation that can exacerbate. METHODS A total of 633 elderly patients with cancer from 29 tertiary public hospitals in 14 cities in China were selected as the research subjects. Physical examination, questionnaire survey, medical history collection, and blood index detection were performed on the research subjects to analyze the relationship between malnutrition, nutritional support, and infection status. RESULTS There was no significant difference in infection rate among elderly hospitalized patients with cancer and different cancer types, cancer stages, or therapy methods (P > 0.05). The proportion of vomiting, loss of appetite, depression, and physical fatigue in patients with good nutritional status were lower than in patients with moderate or severe malnutrition (P < 0.05). Nutritional support is crucial for the nutritional status of elderly patients with cancer, and patients without special nutritional guidance are more likely to develop infection (P < 0.05). After adjusting for confounding variables, the results of the logistic regression analysis showed that oral nutritional supplements (odds ratio [OR]: 0.088; 95% confidence interval [CI], 0.015-0.514), parenteral nutrition (OR: 0.091; 95% CI, 0.011-0.758), and individualized nutritional guidance (OR: 0.026; 95% CI, 0.003-0.202) were all protective factors associated with cancer infection. CONCLUSIONS Many elderly hospitalized patients with cancer have local or systemic infections, and good nutrition is associated with lower rates of infection. Receiving nutritional guidance or support is associated with lower infection rates in elderly patients with cancer.
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Affiliation(s)
- Wanyang Li
- Department of Clinical Nutrition, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yaming Yang
- Department of Nutrition, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zijian Li
- Department of General Surgery, Department of Gastrointestinal Surgery, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Chen
- Department of Clinical Nutrition, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Bernstein RT, Garner-Purkis A, Gallagher JE, Newland-Pedley, Scambler S. A systematic review of social impacts of treatment and rehabilitation of head and neck cancer patients. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2023. [DOI: 10.1016/j.adoms.2023.100409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Matthews S, Brett J, Ramluggun P, Watson E. The psychosocial experiences of human papillomavirus (HPV) positive oropharyngeal cancer patients following (chemo)radiotherapy: A systematic review and meta-ethnography. Psychooncology 2022; 31:2009-2019. [PMID: 35726440 PMCID: PMC10084069 DOI: 10.1002/pon.5984] [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: 11/29/2021] [Revised: 06/01/2022] [Accepted: 06/04/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The UK incidence of oropharyngeal cancer has risen sharply over the last 30 years with an increase in human papillomavirus (HPV) associated diagnoses, most prevalent in younger, working age populations. This meta-ethnography explores the psychosocial needs of HPV+ve oropharyngeal cancer patients during early recovery following (chemo)radiotherapy. METHODS Meta-ethnography methods were used, based on the approach of Noblit and Hare. Systematic searches for relevant qualitative studies were conducted in five electronic databases (MEDLINE, PubMed, CINAHL, PsycINFO and Cochrane database) between 2010 and 2021, followed by citation searching. RESULTS Twenty-three papers exploring the psychosocial needs of HPV+ve oropharyngeal cancer patients after treatment were included. Findings were synthesised to develop five constructs: 'gaps in continuity of support from healthcare professionals' reflecting unmet needs; 'changes to self-identity' revealing the comprehensive disruption of this disease and treatment; 'unrealistic expectations of recovery' highlighting the difficulty of preparing for the impact of treatment; 'finding ways to cope' describing the distinct complexity of this experience; and 'adjusting to life after the end of treatment' exploring how coping strategies helped patients to regain control of their lives. CONCLUSIONS Completing (chemo)radiotherapy signalled a transition from hospital-based care to home-based support, challenging patients to address the constructs identified. An unexpectedly difficult and complex recovery meant that despite a favourable prognosis, poor psychosocial well-being may threaten a successful outcome. The provision of tailored support is essential to facilitate positive adjustment.
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Affiliation(s)
- Sara Matthews
- Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Jo Brett
- Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Pras Ramluggun
- Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Eila Watson
- Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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Muacevic A, Adler JR, Piercy J, Ganti SS, Moka N. Colorectal Adenocarcinoma Metastasis to the Hard Palate: An Uncommon Site of Metastasis for a Common Malignancy. Cureus 2022; 14:e33082. [PMID: 36721535 PMCID: PMC9883981 DOI: 10.7759/cureus.33082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 12/30/2022] Open
Abstract
Colorectal adenocarcinoma (CRC) most commonly metastasizes to the peritoneum, liver, lung, and bone. Metastasis to the oral cavity is uncommon. Here, we report the case of a 74-year-old man who presented with a few months of chewing and swallowing difficulty, shoulder pain, and weight loss of 30 pounds. On oral exam, he was noted to have a 5 cm fixed hard palate mass. Primary hard palate malignancy was initially suspected. Biopsy of the mass confirmed adenocarcinoma with an immunohistochemical pattern suggestive of colorectal origin. He was later found to have extensive skeletal metastasis. Palliative radiotherapy to the hard palate region was initiated, followed by palliative systemic chemotherapy. We have found only three other published cases of rectal adenocarcinoma with hard palate metastasis.
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Pattern of nutritional status in node-negative versus node-positive head and neck cancer patients undergoing treatment: a prospective cohort study. Support Care Cancer 2022; 30:8029-8039. [PMID: 35767086 DOI: 10.1007/s00520-022-07245-6] [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: 11/13/2021] [Accepted: 06/20/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE The aim of this study was to study the nutritional profile of node-negative and node-positive patients undergoing treatment for head and neck squamous cell cancer (HNSCC). METHODS This prospective cohort study was conducted between 2018 and 2020. Patients diagnosed with HNSCC, planned for treatment, were enrolled after written informed consent. In node-negative (N0) and node-positive (N +) cohorts of patients, nutritional status was determined using anthropometric measures and Subjective Global Assessment (SGA) scale pre-treatment, and during and after treatment. Statistical analysis was performed using SPSS version 22. Data was analyzed using parametric and non-parametric tests, and p value of 0.05 was considered significant. RESULTS In total, 161 patients were analyzed, 73 N0 and 88 N + cohorts. Pre-treatment, 9.6 to 20.4% patients in N0 and 23.9 to 32.8% patients in N + cohorts were malnourished. Incidence of malnutrition at completion of treatment was 40.8 to 52.5% overall, 20.5 to 41.1% N0, and 39.5 to 62.8% N + . Mean reduction in weight (11.1% ± 7.82 vs 6.26% ± 8.3, p = 0.000), mean reduction in BMI (2.57 ± 1.87 vs 1.29 ± 1.62, p = 0.000), median reduction in MUAC (2 cm vs 1 cm, p = 0.000), and median increase in SGA score (13 vs 6, p = 0.000) were higher in multi-modality as compared to those in a single-modality treatment. Similar findings were noted in N0 and N + cohorts. CONCLUSION As compared to N0, N + patients had higher burden of malnutrition at diagnosis, and more worsening of nutritional parameters during treatment. More decline in nutritional status was seen in patients receiving multi-modality as compared to single-modality treatment.
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Duncan S, Walker A, Kumar S, Dundas K, Bell K, Wallis A, Surjan Y, Aly F, Lee M. Novel methodology to quantify dehydration in head and neck cancer radiotherapy using DIXON MRI. J Med Radiat Sci 2022; 69:448-455. [PMID: 35762562 DOI: 10.1002/jmrs.605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Head and neck cancer (HNC) patients are at risk of weight change, due to inadequate nutrition intake or dehydration, when receiving radiotherapy (RT). This study aimed to develop methodology to measure water content changes on magnetic resonance imaging (MRI) scans of the head and neck region over the course of RT. METHODS Retrospective datasets of 54 patients were analysed. Eligible patients had been treated for HNC with cisplatin chemoradiation (CRT) or RT alone and underwent a minimum of 2 MRI scans from weeks 0, 3 and 6 of their treatment. Anatomical regions consisting of ≥90% water, on T2-weighted DIXON MRI sequences, were contoured. Water volume changes of all patients were evaluated, within an anatomically standardised external volume, by comparing the absolute water fraction volume (cc) (VEx90WF) and relative water fraction volume (%) (RelVEx90WF) at weeks 0 and 6 of RT. RESULTS There was a statistically significant difference between the RelVEx90WF at weeks 0 and 6 (P = 0.005). However, no statistically significant difference was identified between weeks 0 and 6 VEx90WF (P = 0.064). There were no statistically significant differences identified between patients who received CRT versus RT alone. CONCLUSION This study developed a novel method for measuring changes in water fraction volumes over time, using T2-weighted DIXON MRIs. The methodology created in this study requires further validation through phantom imaging, with known fat and water values.
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Affiliation(s)
- Sophie Duncan
- Medical Radiation Science (MRS), School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia.,Liverpool and Macarthur Cancer Therapy Centres, Sydney, New South Wales, Australia.,Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia
| | - Amy Walker
- Liverpool and Macarthur Cancer Therapy Centres, Sydney, New South Wales, Australia.,Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.,South West Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Centre for Medical Radiation Physics, University of Wollongong, Wollongong, Australia
| | - Shivani Kumar
- Liverpool and Macarthur Cancer Therapy Centres, Sydney, New South Wales, Australia.,Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.,South West Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Kylie Dundas
- Liverpool and Macarthur Cancer Therapy Centres, Sydney, New South Wales, Australia.,Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.,South West Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Katherine Bell
- Dietetics Department, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Andrew Wallis
- Liverpool and Macarthur Cancer Therapy Centres, Sydney, New South Wales, Australia
| | - Yolanda Surjan
- Medical Radiation Science (MRS), School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia.,The University of Newcastle, College of Health and Wellbeing, Callaghan, New South Wales, Australia
| | - Farhannah Aly
- Liverpool and Macarthur Cancer Therapy Centres, Sydney, New South Wales, Australia.,Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.,South West Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Mark Lee
- Liverpool and Macarthur Cancer Therapy Centres, Sydney, New South Wales, Australia.,South West Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
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Corrigan KL, De B, Rooney MK, Ludmir EB, Das P, Smith GL, Taniguchi CM, Minsky BD, Koay EJ, Koong AC, Holliday EB. Patient-Reported Outcomes Following Chemoradiation in Patients with Anal Cancer: A Qualitative Analysis. Adv Radiat Oncol 2022; 7:100986. [PMID: 35662810 PMCID: PMC9157211 DOI: 10.1016/j.adro.2022.100986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/21/2022] [Indexed: 11/29/2022] Open
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Wang P, Zheng X, Luo Z, Wang Y, Guo Z, Zhou Y. Perceptions and experiences of nutritional management needs for patients with esophageal cancer during the peri-radiotherapy period: A qualitative study. Asia Pac J Oncol Nurs 2022; 9:202-209. [PMID: 35571626 PMCID: PMC9096731 DOI: 10.1016/j.apjon.2022.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 01/09/2022] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Malnutrition in patients with esophageal cancer is a major health problem. However, the information about the perceptions and experiences of nutritional management needs during the peri-radiotherapy period is lacking. This study aimed to understand the experiences of, and perspectives on, nutritional management needs of patients with esophageal cancer, family caregivers, doctors, and nurses so as to explore the influencing factors and coping strategies to meet nutritional management needs for patients with esophageal cancer during the peri-radiotherapy period. METHODS A qualitative study with purposive and theoretical sampling was used in this study. One-to-one and focus group interviews were held among patients, main family caregivers, doctors, and nurses in a tertiary general hospital and a tertiary cancer hospital in Shantou, south of China, from August to September in 2020. Data were analyzed using grounded theory by a three-level coding method. The reporting of this study adhered to the COREQ guidelines. RESULTS A total of 12 patients, 10 main family caregivers, 6 doctors, and 9 nurses were interviewed. According to the participants, the three main categories, "personal cognition," "family and social factors," and "nutritional management environment and system," were the main factors influencing nutritional management needs. "Lack of nutrition-related cognition," "effects of feeding-related symptom clusters," and "motivation" were the three major factors that constituted participants' personal cognition on nutritional management. "Dietary conditions in medical institutions," "nutritional management system in medical institutions," and "home nutritional care" were the main components of the nutritional management environment and system. The coping strategies included standardized nutritional training for staff, patients and caregivers, social support system, discharge preparation services, multidisciplinary nutritional management, and construction of the organization and management system. CONCLUSIONS Malnutrition in patients with esophageal cancer who suffer from great diet pain during the peri-radiotherapy period has become a concerning health issue. It is still challenging and needs more nutritional research. The full identification of influencing factors for nutritional management needs and the proposal of coping strategies may help provide theoretical support and a practical basis for constructing a tumor nutritional management scheme to meet the needs of patients with esophageal cancer.
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Affiliation(s)
- Peiru Wang
- Department of Nursing, Shantou Central Hospital, Shantou, China
| | - Xiang Zheng
- Department of Radiotherapy, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Zebing Luo
- Shantou University Medical College, Shantou, China
| | - Yiru Wang
- Department of Nursing, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Zhijun Guo
- Department of Nursing, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Yuhua Zhou
- Department of Nursing, Shantou Central Hospital, Shantou, China
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Wang Y, Zhao D, Lu Q, Zhang L, Zhang T, Sun Y, Xiao S, Zhang Y, Gong L, Wang W. Nutritional counseling was not enough to maintain dietary intake and nutritional status in head and neck cancer patients undergoing radiotherapy: a historical control study for future intervention in China. Asia Pac J Oncol Nurs 2022; 9:190-196. [PMID: 35571622 PMCID: PMC9096730 DOI: 10.1016/j.apjon.2022.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 01/29/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Methods Results Conclusions Nutritional counseling could improve intake, weight and nutritional status of HNC patients during RT to some degree. Only nutritional counseling is not enough to keep adequate intake and good nutritional status. Healthcare professionals should build multidisciplinary teams and conduct the stepwise nutritional support.
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Affiliation(s)
- Yujie Wang
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, Beijing, China
| | - Dan Zhao
- Department of Radiation Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Qian Lu
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, Beijing, China
- Corresponding author.
| | - Lichuan Zhang
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, Beijing, China
| | - Tong Zhang
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, Beijing, China
| | - Yan Sun
- Department of Radiation Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Shaowen Xiao
- Department of Radiation Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Yaru Zhang
- Department of Radiation Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Liqing Gong
- Department of Nutrition, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Weihu Wang
- Department of Radiation Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
- Corresponding author.
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15
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de Oliveira Faria S, Simões Lima GA, Lopes Carvalho A, Nader Marta G, Howell D, Eluf-Neto J. Clinically significant changes in health-related quality of life in head and neck cancer patients following intensive nutritional care during radiotherapy. Eur J Oncol Nurs 2021; 56:102065. [PMID: 34826722 DOI: 10.1016/j.ejon.2021.102065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE This study aimed to explore whether adherence to intensive nutritional care during radiotherapy would avoid a meaningful worsening in quality of life in head and neck cancer patients; and whether adherence was associated with better nutritional outcomes. METHODS Observational prospective study that assessed head and neck cancer patients treated with radiotherapy at a large oncology hospital, between August 2018 and April 2019. The main outcome was minimal clinically important difference in quality of life, assessed with EORTC QLQ-C30 and EORTC QLQ H&N35, between baseline and 12 weeks. To illustrate clinically significant changes in quality of life over timeby adherence, a heat map analysis was performed. We also evaluated nutritional outcomes. RESULTS Eighty patients were included, half of them (53.8%) were considered adherent. There were no significant difference in quality of life between groups at baseline, with the exception of swallowing (p = 0.029) and coughing (p < 0.01). After treatment, the heat map demonstrated that adherent patients had nonsignificant clinical change in function scales, while non-adherent patients had a clinically significant worsening in physical, cognitive and social function. The prevalence of malnutrition increased significantly only in non-adherent patients (p < 0.01). CONCLUSION Adherence to intensive nutritional care may be able to avoid a meaningful worsening in quality of life and result in better nutritional outcomes in head and neck cancer patients. Our results may help to increase the awareness of the assessment of adherence and minimal clinically important difference in quality of life for research purposes and clinical practice.
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Affiliation(s)
- Sheilla de Oliveira Faria
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil; Princess Margaret Cancer Centre Research Institute, Toronto, Ontario, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
| | - Graziele Aparecida Simões Lima
- Departamento de Nutrição, Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | | | | | - Doris Howell
- Princess Margaret Cancer Centre Research Institute, Toronto, Ontario, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Jose Eluf-Neto
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
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16
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Zheng Z, Zhao X, Zhao Q, Zhang Y, Liu S, Liu Z, Meng L, Xin Y, Jiang X. The Effects of Early Nutritional Intervention on Oral Mucositis and Nutritional Status of Patients With Head and Neck Cancer Treated With Radiotherapy. Front Oncol 2021; 10:595632. [PMID: 33598427 PMCID: PMC7882690 DOI: 10.3389/fonc.2020.595632] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/14/2020] [Indexed: 12/16/2022] Open
Abstract
Radiation-induced oral mucositis (RIOM) is a common side effect after radiotherapy (RT) in head and neck cancer (HNC) patients. RIOM patients with severe pain have difficulty in eating, which increases the incidence of malnutrition and affects patients' quality of life and the process of RT. The mechanism of RIOM is not fully understood, and inflammatory response and oxidative stress appear to be important for RIOM occurrence and development. The nutritional status of patients is very important for their RT tolerance and recovery. Malnutrition, which can lead to anemia, low protein, decreased immunity and other problems, is an important clinical factor affecting tumor progression and treatment. Recent studies have shown that early nutritional intervention can ameliorate oral mucositis and nutritional status of patients with HNC. However, in clinical practice, early nutritional intervention for patients with HNC is not a conventional intervention strategy. Therefore, this review summarized the possible pathogenesis of RIOM, commonly used assessment tools for malnutrition in patients, and recent studies on the effects of early nutritional interventions on RIOM and nutritional status of patients with HNC. We hope to provide the basis and reference for the clinical application of early nutritional intervention models.
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Affiliation(s)
- Zhuangzhuang Zheng
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China
- NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China
| | - Xin Zhao
- Department of Orthopedic, The Second Hospital of Jilin University, Changchun, China
| | - Qin Zhao
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China
- NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China
| | - Yuyu Zhang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China
- NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China
| | - Shiyu Liu
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China
- NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China
| | - Zijing Liu
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China
- NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China
| | - Lingbin Meng
- Department of Hematology and Medical Oncology, Moffitt Cancer Center, Tampa, FL, United States
| | - Ying Xin
- Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun, China
| | - Xin Jiang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China
- NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China
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17
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Bye A, Sandmael JA, Stene GB, Thorsen L, Balstad TR, Solheim TS, Pripp AH, Oldervoll LM. Exercise and Nutrition Interventions in Patients with Head and Neck Cancer during Curative Treatment: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:E3233. [PMID: 33105699 PMCID: PMC7690392 DOI: 10.3390/nu12113233] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/14/2020] [Accepted: 10/20/2020] [Indexed: 12/19/2022] Open
Abstract
The aim of this meta-analysis was to examine the effects of nutritional and physical exercise interventions and interventions combining these interventions during radiotherapy treatment for patients with head and neck cancer on body composition, objectively measured physical function and nutritional status. Systematic electronic searches were conducted in MEDLINE (PubMed interface), EMBASE (Ovid interface), CINAHL (EBSCO interface) and Cochrane Library (Wiley interface). We identified 13 randomized controlled trials (RCTs) that included 858 patients. For body composition, using only nutrition as intervention, a significant difference between treatment and control group were observed (SMD 0.42 (95CI 0.23-0.62), p < 0.001). Only pilot RCTs investigated combination treatment and no significant difference between the treatment and control groups were found (SMD 0.21 (95CI -0.16-0.58), p = 0.259). For physical function, a significant difference between treatment and control group with a better outcome for the treatment group were observed (SMD 0.78 (95CI 0.51-1.04), p < 0.001). No effects on nutritional status were found. This meta-analysis found significantly positive effects of nutrition and physical exercise interventions alone in favor of the treatment groups. No effects in studies with combined interventions were observed. Future full-scaled RCTs combining nutrition and physical exercise is warranted.
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Affiliation(s)
- Asta Bye
- Faculty of Health Sciences, OsloMet—Oslo Metropolitan University, 0130 Oslo, Norway;
- Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital, 0424 Oslo, Norway
| | | | - Guro B. Stene
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway; (G.B.S.); (T.R.B.); (T.S.S.)
- Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
| | - Lene Thorsen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, 0424 Oslo, Norway;
- Department for Clinical Service, Division of Cancer Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - Trude R. Balstad
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway; (G.B.S.); (T.R.B.); (T.S.S.)
- Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
| | - Tora S. Solheim
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway; (G.B.S.); (T.R.B.); (T.S.S.)
- Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
| | - Are Hugo Pripp
- Faculty of Health Sciences, OsloMet—Oslo Metropolitan University, 0130 Oslo, Norway;
- Oslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, 0424 Oslo, Norway
| | - Line M. Oldervoll
- Center for Crisis Psychology, Faculty of Psychology, University of Bergen, 5020 Bergen, Norway;
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, The Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
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18
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Narayanan S, Nagengast A, Hussain A, Badugu P, Elnazeir M, Jones CM. Palliative Considerations Regarding Enteral Access in Surgical Patients. CURRENT SURGERY REPORTS 2020. [DOI: 10.1007/s40137-020-00249-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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19
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Kristensen MB, Wessel I, Beck AM, Dieperink KB, Mikkelsen TB, Møller JJK, Zwisler AD. Rationale and design of a randomised controlled trial investigating the effect of multidisciplinary nutritional rehabilitation for patients treated for head and neck cancer (the NUTRI-HAB trial). Nutr J 2020; 19:21. [PMID: 32183835 PMCID: PMC7079410 DOI: 10.1186/s12937-020-00539-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/03/2020] [Indexed: 12/24/2022] Open
Abstract
Background Eating problems frequently affect quality of life and physical, psychological and social function in patients treated for head and neck cancer (HNC). Residential rehabilitation programmes may ameliorate these adverse effects but are not indicated for all individuals. Systematic assessment of rehabilitation needs may optimise the use of resources while ensuring referral to rehabilitation for those in need. Yet, evidence lacks on which nutrition screening and assessment tools to use. The trial objectives are: 1) To test the effect of a multidisciplinary residential nutritional rehabilitation programme compared to standard care on the primary outcome body weight and secondary outcomes health-related quality of life, physical function and symptoms of anxiety and depression in patients curatively treated for HNC and 2) To test for correlations between participants’ development in outcome scores during their participation in the programme and their baseline scores in Nutritional Risk Screening 2002 (NRS 2002), the Scored Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF), and M. D. Anderson Dysphagia Inventory (MDADI) and to assess sensitivity, specificity and predictive values of the three tools in relation to a clinically relevant improvement in outcome scores. Methods In a randomised controlled trial, 72 patients treated for HNC recruited through a nationwide survey will be randomised to a multidisciplinary residential nutritional rehabilitation programme or to a wait-list control group. Data are collected at baseline, three and six months. Primary outcome is change in body weight, and secondary outcomes include changes in quality of life, physical function and symptoms of anxiety and depression. Potential correlations between intervention effect and baseline scores in NRS 2002, PG-SGA-SF and MDADI will be tested, and sensitivity, specificity and predictive values of the three tools in relation to a clinically relevant improvement in outcome scores will be assessed. Discussion This is the first randomised controlled trial to test the effect of a multidisciplinary residential nutritional rehabilitation programme in patients treated for HNC. Recruitment through a nationwide survey gives a unique possibility to describe the trial population and to identify potential selection bias. As the trial will explore the potential of different nutrition screening and assessment tools in the assessment of rehabilitation needs in patients treated for HNC, the trial will create knowledge about how selection and prioritisation of nutritional rehabilitation aimed at patients treated for HNC should be offered. The results may contribute to a better organisation and use of existing resources in benefit of patients treated for HNC. Trial registration The trial is registered by The Danish Data Protection Agency (registration 2012-58-0018, approval number 18/14847) and the Regional Committees on Health Research Ethics for Southern Denmark (journal number 20182000–165). ClinicalTrials.gov Identifier: NCT03909256. Registered April 9, 2019.
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Affiliation(s)
- Marianne Boll Kristensen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Odense University Hospital, Vestergade 17, Nyborg, DK-5800, Denmark. .,Department of Nursing and Nutrition, University College Copenhagen, Sigurdsgade 26, DK-2200, Copenhagen N, Denmark. .,OPEN, Odense Patient data Explorative Network, Odense University Hospital, J.B. Winsløws Vej 9A, DK-5000, Odense C, Denmark.
| | - Irene Wessel
- Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen Ø, Denmark
| | - Anne Marie Beck
- Department of Nursing and Nutrition, University College Copenhagen, Sigurdsgade 26, DK-2200, Copenhagen N, Denmark.,Dietetics and Clinical Nutrition Research Unit, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 50, 4, DK- 2730, Herlev, Denmark
| | - Karin B Dieperink
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Odense University Hospital, Vestergade 17, Nyborg, DK-5800, Denmark.,Research Unit of Oncology, Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.,Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19.3, 5000, Odense C, Denmark
| | - Tina Broby Mikkelsen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Odense University Hospital, Vestergade 17, Nyborg, DK-5800, Denmark
| | - Jens-Jakob Kjer Møller
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Odense University Hospital, Vestergade 17, Nyborg, DK-5800, Denmark
| | - Ann-Dorthe Zwisler
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Odense University Hospital, Vestergade 17, Nyborg, DK-5800, Denmark
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