Journal
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
Volume 45, Issue 1, Pages 156-166Publisher
WILEY
DOI: 10.1002/hed.27220
Keywords
enhanced recovery after surgery; head and neck cancer; nutrition counseling; nutrition support; randomized controlled trial
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Several prospective studies suggest that pretreatment nutrition interventions before radiation therapy for head and neck cancer can improve outcomes, but there are no studies assessing similar interventions before surgery for head and neck cancer.
Background Several prospective studies report improved outcomes with pretreatment nutrition interventions prior to radiation therapy for head and neck cancer (HNC), but none have assessed similar interventions before surgery for HNC. Methods POINT, a pilot randomized controlled trial, was conducted to evaluate a multimodal nutrition intervention. Patients undergoing primary surgery with free flap reconstruction for HNC were randomly assigned to the control arm or a preoperative multimodal nutrition intervention. Results POINT included 49 patients. Nutrition risk scores did not change significantly for either the intervention or control group. Control patients had a significant decrease in body weight in the preoperative period (p < 0.001). Conversely, weight among intervention patients did not significantly decrease (p = 0.680). The intervention mitigated weight loss in patients with dysphagia (p = 0.001). Conclusions Preoperative nutrition optimization shows potential to reduce weight loss normally experienced by patients with head and neck cancer prior to surgical extirpation, especially among those with subjective dysphagia.
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