Influence of nutritional counseling on treatment results in patients with head and neck cancers

Aleksandra Krzywon; Anna Kotylak; Alexander Jorge Cortez; Jolanta Mrochem-Kwarciak; Krzysztof Składowski; Tomasz Rutkowski

doi:10.1016/j.nut.2023.112187

Influence of nutritional counseling on treatment results in patients with head and neck cancers

Nutrition. 2023 Dec:116:112187. doi: 10.1016/j.nut.2023.112187. Epub 2023 Aug 6.

Authors

Aleksandra Krzywon¹, Anna Kotylak², Alexander Jorge Cortez³, Jolanta Mrochem-Kwarciak⁴, Krzysztof Składowski², Tomasz Rutkowski⁵

Affiliations

¹ Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland. Electronic address: aleksandra.krzywon@gliwice.nio.gov.pl.
² I Radiation and Clinical Oncology Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland.
³ Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland.
⁴ Analytics and Clinical Biochemistry Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland.
⁵ Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland. Electronic address: tomasz.rutkowski@gliwice.nio.gov.pl.

PMID: 37683314
DOI: 10.1016/j.nut.2023.112187

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.

Keywords: Dietitian; Head and neck cancer; Nutrition; Nutritional counseling; Oral nutritional supplements; Weight loss.

MeSH terms

Counseling
Female
Head and Neck Neoplasms* / therapy
Humans
Male
Nutrition Therapy*
Oropharyngeal Neoplasms*
Weight Loss