scholarly journals Nutritional Support in Head and Neck Radiotherapy Patients Considering HPV Status

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 57
Author(s):  
Adam Brewczyński ◽  
Beata Jabłońska ◽  
Sławomir Mrowiec ◽  
Krzysztof Składowski ◽  
Tomasz Rutkowski
Keyword(s):  
Head And Neck ◽  
Nutritional Support ◽  
Nutritional Intervention ◽  
Nutritional Risk ◽  
Percutaneous Gastrostomy ◽  
Critical Weight ◽  
Oncological Treatment ◽  
Feeding Tubes ◽  
Hpv Status ◽  
Percutaneous Gastrostomy Tube

Malnutrition is a common problem in patients with head and neck cancer (HNC), including oropharyngeal cancer (OPC). It is caused by insufficient food intake due to dysphagia, odynophagia, and a lack of appetite caused by the tumor. It is also secondary to the oncological treatment of the basic disease, such as radiotherapy (RT) and chemoradiotherapy (CRT), as a consequence of mucositis with the dry mouth, loss of taste, and dysphagia. The severe dysphagia leads to a definitive total impossibility of eating through the mouth in 20–30% of patients. These patients usually require enteral nutritional support. Feeding tubes are a commonly used nutritional intervention during radiotherapy, most frequently percutaneous gastrostomy tube. Recently, a novel HPV-related type of OPC has been described. Patients with HPV-associated OPC are different from the HPV− ones. Typical HPV− OPC is associated with smoking and alcohol abuse. Patients with HPV+ OPC are younger and healthy (without comorbidities) at diagnosis compared to HPV− ones. Patients with OPC are at high nutritional risk, and therefore, they require nutritional support in order to improve the treatment results and quality of life. Some authors noted the high incidence of critical weight loss (CWL) in patients with HPV-related OPC. Other authors have observed the increased acute toxicities during oncological treatment in HPV+ OPC patients compared to HPV− ones. The aim of this paper is to review and discuss the indications for nutritional support and the kinds of nutrition, including immunonutrition (IN), in HNC, particularly OPC patients, undergoing RT/CRT, considering HPV status.

scholarly journals Perioperative Nutrition in Abdominal Surgery: Recommendations and Reality

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Yannick Cerantola ◽  
Fabian Grass ◽  
Alessandra Cristaudi ◽  
Nicolas Demartines ◽  
Markus Schäfer ◽  
...  
Keyword(s):  
Risk Factor ◽  
Nutritional Support ◽  
Postoperative Outcome ◽  
Nutritional Intervention ◽  
Infectious Complications ◽  
Nutritional Risk ◽  
Major Surgery ◽  
Practical Implementation ◽  
Nutritional Screening ◽  
Perioperative Nutrition

Introduction. Preoperative malnutrition is a major risk factor for increased postoperative morbidity and mortality. Definition and diagnosis of malnutrition and its treatment is still subject for controversy. Furthermore, practical implementation of nutrition-related guidelines is unknown.Methods. A review of the available literature and of current guidelines on perioperative nutrition was conducted. We focused on nutritional screening and perioperative nutrition in patients undergoing digestive surgery, and we assessed translation of recent guidelines in clinical practice.Results and Conclusions. Malnutrition is a well-recognized risk factor for poor postoperative outcome. The prevalence of malnutrition depends largely on its definition; about 40% of patients undergoing major surgery fulfil current diagnostic criteria of being at nutritional risk. TheNutritional Risk Scoreis a pragmatic and validated tool to identify patients who should benefit from nutritional support. Adequate nutritional intervention entails reduced (infectious) complications, hospital stay, and costs. Preoperative oral supplementation of a minimum of five days is preferable; depending on the patient and the type of surgery, immune-enhancing formulas are recommended. However, surgeons' compliance with evidence-based guidelines remains poor and efforts are necessary to implement routine nutritional screening and nutritional support.

Metastasis of untreated head and neck cancer to percutaneous gastrostomy tube exit sites

2012 ◽  
Vol 33 (6) ◽  
pp. 774-778 ◽  
Author(s):  
Kianoush Sheykholeslami ◽  
Jacob Thomas ◽  
Nipun Chhabra ◽  
Tung Trang ◽  
Rod Rezaee
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Gastrostomy Tube ◽  
Percutaneous Gastrostomy ◽  
Tube Exit ◽  
Percutaneous Gastrostomy Tube

NUTRITION ASSESSMENT IN HEAD AND NECK CANCER PATIENTS PRE and POST CHEMORADIOTHERAPY.

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Piyush Kumar ◽  
Bhavya P Pateneedi ◽  
Dharam P Singh ◽  
Arvind K Chauhan
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Nutritional Risk ◽  
Total Leukocyte Count ◽  
Risk Indicator ◽  
Anthropometric Parameters ◽  
Skin Fold Thickness ◽  
Before And After

INTRODUCTION: Head and neck cancer patients are frequently malnourished at the time of diagnosis and prior to the beginning of treatment. Deterioration of the nutritional status results in an increase in chemo radiotherapy related toxicity and this may increase the prolonged treatment time, which has been associated with poor clinical outcome. The present study aims to do nutritional assessment before and after chemo radiotherapy in head and neck cancer patients. MATERIAL AND METHODS: The present study was undertaken at the Department of Radiation Oncology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly. In this study, 50 patients of Head and neck tumours were enrolled and their nutrition was assessed before and after chemoradiotherapy. Nutrition assessment was done using different laboratory parameters like haemoglobin, total leukocyte count, blood urea, serum creatinine and serum bilirubin. Anthropometric parameters used are Body mass index, Skin fold thickness, and Mid-arm circumference. Nutritional risk indicator and PG-SGA score is measured before and after chemoradiotherapy. All the parameters were assessed and analysed using different statistical tests- Chi-square test, Fisher Exact test and paired t test.RESULTS: Haemoglobin decrease was statistically significant during treatment (p less than 0.001) and the decrease in total leukocyte count during treatment was showing trend towards significance (p value-0.056). There was deterioration in other parameters like blood urea, serum creatinine and serum bilirubin but was not statistically significant. Anthropometric parameters- Body mass index, mid-arm circumference and skin fold thickness and percent body fat showed a significant change (p less than 0.00001). Nutritional risk indicator and PG-SGA class has decreased for majority of patients during treatment, the change is statistically significant (p less than 0.00001 and p=0.0251) respectively.CONCLUSION: The nutrition has important role to play in the management of head and neck cancers by chemo radiotherapy. It helps to reduce the complications and improve the tolerance of chemo radiotherapy, thus avoiding treatment breaks which may lead to failure of treatment.

scholarly journals The Individual Effects of Cyclin-Dependent Kinase Inhibitors on Head and Neck Cancer Cells—A Systematic Analysis

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2396
Author(s):  
Nina Schoenwaelder ◽  
Inken Salewski ◽  
Nadja Engel ◽  
Mareike Krause ◽  
Björn Schneider ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Head And Neck ◽  
Kinase Inhibitors ◽  
In Vivo Studies ◽  
Specific Response ◽  
Cyclin Dependent Kinase ◽  
Systematic Analysis ◽  
Mhc I ◽  
Oncological Treatment

Cyclin-dependent kinase inhibitors (CDKi´s) display cytotoxic activity against different malignancies, including head and neck squamous cell carcinomas (HNSCC). By coordinating the DNA damage response, these substances may be combined with cytostatics to enhance cytotoxicity. Here, we investigated the influence of different CDKi´s (palbociclib, dinaciclib, THZ1) on two HNSCC cell lines in monotherapy and combination therapy with clinically-approved drugs (5-FU, Cisplatin, cetuximab). Apoptosis/necrosis, cell cycle, invasiveness, senescence, radiation-induced γ-H2AX DNA double-strand breaks, and effects on the actin filament were studied. Furthermore, the potential to increase tumor immunogenicity was assessed by analyzing Calreticulin translocation and immune relevant surface markers. Finally, an in vivo mouse model was used to analyze the effect of dinaciclib and Cisplatin combination therapy. Dinaciclib, palbociclib, and THZ1 displayed anti-neoplastic activity after low-dose treatment, while the two latter substances slightly enhanced radiosensitivity. Dinaciclib decelerated wound healing, decreased invasiveness, and induced MHC-I, accompanied by high amounts of surface-bound Calreticulin. Numbers of early and late apoptotic cells increased initially (24 h), while necrosis dominated afterward. Antitumoral effects of the selective CDKi palbociclib were weaker, but combinations with 5-FU potentiated effects of the monotherapy. Additionally, CDKi and CDKi/chemotherapy combinations induced MHC I, indicative of enhanced immunogenicity. The in vivo studies revealed a cell line-specific response with best tumor growth control in the combination approach. Global acting CDKi’s should be further investigated as targeting agents for HNSCC, either individually or in combination with selected drugs. The ability of dinaciclib to increase the immunogenicity of tumor cells renders this substance a particularly interesting candidate for immune-based oncological treatment regimens.

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