TY - JOUR
T1 - Impact of nutrition on outcome
T2 - A prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy
AU - Ravasco, Paula
AU - Monteiro-Grillo, Isabel
AU - Vidal, Pedro Marques
AU - Camilo, Maria Ermelinda
PY - 2005/8
Y1 - 2005/8
N2 - Background. We aimed to determine the effect of dietary counseling or oral supplements on outcome for patients with cancer, specifically, nutritional outcome, morbidity, and quality of life (QOL), during and 3 months after radiotherapy. Methods. Seventy-five patients with head and neck cancer who were referred for radiotherapy (RT) were randomized to the following groups: group 1 (n = 25), patients who received dietary counseling with regular foods; group 2 (n = 25), patients who maintained usual diet plus supplements; and group 3 (n = 25), patients who maintained intake ad lib. Nutritional intake (determined by diet history) and status (determined by Ottery's Subjective Global Assessment), and QOL (determined by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire version 3.0 [EORTC QLQ-C30]) were evaluated at baseline, at the end of RT, and at 3 months. Results. Energy intake after RT increased in both groups 1 and 2 (p ≤ .05). Protein intake also increased in both groups 1 and 2 (p ≤ .006). Both energy and protein intake decreased significantly in group 3 (p < .01 ). At 3 months, group 1 maintained intakes, whereas groups 2 and 3 returned to or below baseline levels. After RT, >90% of patients experienced RT toxicity; this was not significantly different between groups, with a trend for reduced symptomatology in group 1 versus group 2/group 3 (p < .07). At 3 months, the reduction of incidence/severity of grade 1+2 anorexia, nausea/vomiting, xerostomia, and dysgeusia was different: 90% of the patients improved in group 1 versus 67% in group 2 versus 51% in group 3 (p < .0001). After RT, QOL function scores improved (p < .003) proportionally with improved nutritional intake and status in group 1/group 2 (p < .05) and worsened in group 3 (p < .05); at 3 months, patients in group 1 maintained or improved overall QOL, whereas patients in groups 2 and 3 maintained or worsened overall QOL. Conclusions. During RT, nutritional interventions positively influenced outcomes, and counseling was of similar/higher benefit; in the medium term, only counseling exerted a significant impact on patient outcomes.
AB - Background. We aimed to determine the effect of dietary counseling or oral supplements on outcome for patients with cancer, specifically, nutritional outcome, morbidity, and quality of life (QOL), during and 3 months after radiotherapy. Methods. Seventy-five patients with head and neck cancer who were referred for radiotherapy (RT) were randomized to the following groups: group 1 (n = 25), patients who received dietary counseling with regular foods; group 2 (n = 25), patients who maintained usual diet plus supplements; and group 3 (n = 25), patients who maintained intake ad lib. Nutritional intake (determined by diet history) and status (determined by Ottery's Subjective Global Assessment), and QOL (determined by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire version 3.0 [EORTC QLQ-C30]) were evaluated at baseline, at the end of RT, and at 3 months. Results. Energy intake after RT increased in both groups 1 and 2 (p ≤ .05). Protein intake also increased in both groups 1 and 2 (p ≤ .006). Both energy and protein intake decreased significantly in group 3 (p < .01 ). At 3 months, group 1 maintained intakes, whereas groups 2 and 3 returned to or below baseline levels. After RT, >90% of patients experienced RT toxicity; this was not significantly different between groups, with a trend for reduced symptomatology in group 1 versus group 2/group 3 (p < .07). At 3 months, the reduction of incidence/severity of grade 1+2 anorexia, nausea/vomiting, xerostomia, and dysgeusia was different: 90% of the patients improved in group 1 versus 67% in group 2 versus 51% in group 3 (p < .0001). After RT, QOL function scores improved (p < .003) proportionally with improved nutritional intake and status in group 1/group 2 (p < .05) and worsened in group 3 (p < .05); at 3 months, patients in group 1 maintained or improved overall QOL, whereas patients in groups 2 and 3 maintained or worsened overall QOL. Conclusions. During RT, nutritional interventions positively influenced outcomes, and counseling was of similar/higher benefit; in the medium term, only counseling exerted a significant impact on patient outcomes.
KW - Dietary counseling
KW - Head-neck cancer
KW - Morbidity
KW - Outcomes
KW - Quality of life
KW - Radiotherapy
KW - Supplements
KW - Wasting
UR - http://www.scopus.com/inward/record.url?scp=23444450540&partnerID=8YFLogxK
U2 - 10.1002/hed.20221
DO - 10.1002/hed.20221
M3 - Article
C2 - 15920748
AN - SCOPUS:23444450540
SN - 1043-3074
VL - 27
SP - 659
EP - 668
JO - Head and Neck
JF - Head and Neck
IS - 8
ER -