The Impact of Active Nutritional Support for Head and Neck Cancer Patients Receiving Concurrent Chemoradiotherapy

Vutisiri Veerasarn; Nattapatch Janhom; Yaowalak Chansilpa; Nan Suntornpong; Kullathorn Thephamongkhol; Nantakan Apiwarodom; Janjira Petsuksiri; Pittaya Dankulchai; Jiraporn Setakornnukul; Achiraya Teyateeti; Warissara Rongthong; Panid Chaysiri

doi:10.33192/Smj.2020.07

Authors

Vutisiri Veerasarn Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0002-9601-994X
Nattapatch Janhom Department of Radiology, Rajavithi Hospital, Bangkok 10400 http://orcid.org/0000-0001-5640-3579
Yaowalak Chansilpa Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0001-7026-3955
Nan Suntornpong Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0001-7453-226X
Kullathorn Thephamongkhol Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0002-0998-8874
Nantakan Apiwarodom Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0002-1211-2275
Janjira Petsuksiri Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0002-2334-4899
Pittaya Dankulchai Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0003-1150-1399
Jiraporn Setakornnukul Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0002-7201-0377
Achiraya Teyateeti Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0001-5421-4248
Warissara Rongthong Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0003-1697-905X
Panid Chaysiri Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0002-1250-544X

DOI:

https://doi.org/10.33192/Smj.2020.07

Keywords:

Head and neck cancer; radiotherapy; chemotherapy; chemoradiotherapy; nutrition.

Abstract

Objective: Malnutrition is the most common problem in head and neck cancer (HNC) patients receiving concurrent chemoradiotherapy. The radiation toxicities cause decreased food intake, with resultant severe weight loss and malnutrition. This study sought to determine whether an active nutrition improvement counseling program before and during concurrent chemoradiotherapy for HNC patients could increase the treatment completion rate without the interruptions caused by the side effects of chemoradiotherapy.
Methods: The findings of a prospective study of the effects of an active nutrition improvement program before and during concurrent chemoradiotherapy (study, n = 32) was compared with those of a retrospective chart review of HNC patients who had received definite or postoperative concurrent chemoradiotherapy (control, n = 80). The correlations between nutritional status and the number of treatment completions, number of tube feeding insertions during treatment, RTOG toxicity, nutritional status, and quality of life were obtained.
Results: There was no statistically significant difference between the concurrent chemoradiotherapy completion rates of both groups (p = 0.121; 95% CI, 0.226-1.188). The major cause of delayed or discontinued chemotherapy was oral mucositis. No significant differences were found in the tube feeding insertion rates and RTOG toxicities of both groups. However, the data showed a clinically significant difference in the concurrent chemoradiotherapy completion rate for the study group (56%), more than 15 percentage points higher than the control group’s rate (40%).
Conclusion: An active nutrition improvement program before and during concurrent chemoradiotherapy is clinically beneficial for HNC patients, providing a higher treatment completion rate than otherwise.

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