Nutritional interventions in patients with head and neck cancer undergoing chemoradiotherapy: Current practice at the Dutch Head and Neck Oncology centres

doi:10.1111/ecc.13518

. 2022 Jan;31(1):e13518.

doi: 10.1111/ecc.13518. Epub 2021 Oct 12.

Nutritional interventions in patients with head and neck cancer undergoing chemoradiotherapy: Current practice at the Dutch Head and Neck Oncology centres

Annemieke Kok¹, Carlijn van der Lugt^{1

2}, Marja J Leermakers-Vermeer¹, Nicole M de Roos², Caroline M Speksnijder^{3

4}, Remco de Bree⁴

Affiliations

¹ Department of Dietetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
² Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
³ Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
⁴ Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

PMID: 34637563
PMCID: PMC9285387
DOI: 10.1111/ecc.13518

Nutritional interventions in patients with head and neck cancer undergoing chemoradiotherapy: Current practice at the Dutch Head and Neck Oncology centres

Annemieke Kok et al. Eur J Cancer Care (Engl). 2022 Jan.

. 2022 Jan;31(1):e13518.

doi: 10.1111/ecc.13518. Epub 2021 Oct 12.

Authors

Annemieke Kok¹, Carlijn van der Lugt^{1

2}, Marja J Leermakers-Vermeer¹, Nicole M de Roos², Caroline M Speksnijder^{3

4}, Remco de Bree⁴

Affiliations

¹ Department of Dietetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
² Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
³ Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
⁴ Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

PMID: 34637563
PMCID: PMC9285387
DOI: 10.1111/ecc.13518

Abstract

Objective: To assess variations in nutritional interventions during chemoradiotherapy (CRT) among the Dutch Head and Neck Oncology centres (HNOCs).

Methods: An online questionnaire about nutritional interventions and dietetic practices was sent to 14 oncology dietitians of the HNOCs.

Results: The response rate was 93%. The number of scheduled dietetic consultations varied from two to seven during CRT. Most centres (77%) reported using a gastrostomy for tube feeding in the majority of patients. Gastrostomies were placed prophylactically upon indication (39%) or in all patients (15%), reactive (15%), or both (31%). For calculating energy requirements, 54% of the dietitians used the Food and Agriculture Organization/World Health Organization and United Nations University (FAO/WHO/UNU) formula and 77% uses 1.2-1.5 g/kg body weight for calculating protein requirements. Almost half of the centres (46%) reported to remove the gastrostomy between 8 and 12 weeks after CR. Most centres (92%) reported to end dietary treatment within 6 months after CRT.

Conclusion: This study shows substantial variation in dietetic practice, especially in the use of a gastrostomy for tube feeding, between the HNOCs. There is a need for concise dietetic guidelines.

Keywords: chemoradiotherapy; diet therapy; enteral nutrition; gastrostomy; head and neck neoplasms; nutritional intervention.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

**FIGURE 1**
Estimated average time of gastrostomy removal after end of CRT treatment as reported by the 13 dietitians of the participating centres

See this image and copyright information in PMC

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[1] Arends, J. , Bachmann, P. , Baracos, V. , Barthelemy, N. , Bertz, H. , Bozzetti, F. , & Preiser, J. C. (2016). ESPEN guidelines on nutrition in cancer patients. Clinical Nutrition, 36(1), 11–48. 10.1016/j.clnu.2016.07.015 - DOI - PubMed

[2] Arends, J. , Bachmann, P. , Baracos, V. , Barthelemy, N. , Bertz, H. , Bozzetti, F. , & Preiser, J. C. (2016). ESPEN guidelines on nutrition in cancer patients. Clinical Nutrition, 36(1), 11–48. 10.1016/j.clnu.2016.07.015 - DOI - PubMed

[3] Beijer, S. D. P. , Doornink, N. , ten Have, H. , van Lieshout, R. , & Vogel, J. (2016). Voedingsbehoefte en voedingsadvies. In Vogel J. (Ed.), Handboek voeding bij kanker (second ed.) (pp. 64–80). De Tijdstroom.

[4] Beijer, S. D. P. , Doornink, N. , ten Have, H. , van Lieshout, R. , & Vogel, J. (2016). Voedingsbehoefte en voedingsadvies. In Vogel J. (Ed.), Handboek voeding bij kanker (second ed.) (pp. 64–80). De Tijdstroom.

[5] Berthiller, J. , Straif, K. , Agudo, A. , Ahrens, W. , Bezerra Dos Santos, A. , Boccia, S. , & Lee, Y. C. (2016). Low frequency of cigarette smoking and the risk of head and neck cancer in the INHANCE consortium pooled analysis. International Journal of Epidemiology, 45(3), 835–845. 10.1093/ije/dyv146 - DOI - PMC - PubMed

[6] Berthiller, J. , Straif, K. , Agudo, A. , Ahrens, W. , Bezerra Dos Santos, A. , Boccia, S. , & Lee, Y. C. (2016). Low frequency of cigarette smoking and the risk of head and neck cancer in the INHANCE consortium pooled analysis. International Journal of Epidemiology, 45(3), 835–845. 10.1093/ije/dyv146 - DOI - PMC - PubMed

[7] Bressan, V. , Stevanin, S. , Bianchi, M. , Aleo, G. , Bagnasco, A. , & Sasso, L. (2016). The effects of swallowing disorders, dysgeusia, oral mucositis and xerostomia on nutritional status, oral intake and weight loss in head and neck cancer patients: A systematic review. Cancer Treatment Reviews, 45, 105–119. 10.1016/j.ctrv.2016.03.006 - DOI - PubMed

[8] Bressan, V. , Stevanin, S. , Bianchi, M. , Aleo, G. , Bagnasco, A. , & Sasso, L. (2016). The effects of swallowing disorders, dysgeusia, oral mucositis and xerostomia on nutritional status, oral intake and weight loss in head and neck cancer patients: A systematic review. Cancer Treatment Reviews, 45, 105–119. 10.1016/j.ctrv.2016.03.006 - DOI - PubMed

[9] Brown, T. , Banks, M. , Hughes, B. G. M. , Lin, C. , Kenny, L. M. , & Bauer, J. D. (2017a). Impact of early prophylactic feeding on long term tube dependency outcomes in patients with head and neck cancer. Oral Oncology, 72, 17–25. 10.1016/j.oraloncology.2017.06.025 - DOI - PubMed

[10] Brown, T. , Banks, M. , Hughes, B. G. M. , Lin, C. , Kenny, L. M. , & Bauer, J. D. (2017a). Impact of early prophylactic feeding on long term tube dependency outcomes in patients with head and neck cancer. Oral Oncology, 72, 17–25. 10.1016/j.oraloncology.2017.06.025 - DOI - PubMed

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Nutritional interventions in patients with head and neck cancer undergoing chemoradiotherapy: Current practice at the Dutch Head and Neck Oncology centres

Affiliations

Nutritional interventions in patients with head and neck cancer undergoing chemoradiotherapy: Current practice at the Dutch Head and Neck Oncology centres

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