Investigating adherence to Australian nutritional care guidelines in patients with head and neck cancer

Sophie Hofto, Jessica Abbott, James Jackson, Elisabeth Isenring

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Abstract

Background
Significant weight loss and malnutrition are common in patients with head and neck cancer, despite advances in treatment and development of evidenced-based guidelines. The aim of this study was to assess adherence to evidenced-based guidelines and investigate nutrition outcomes during and post radiation treatment in head and neck cancer patients.

Methods
This was a two-year retrospective cohort study of 209 head and neck cancer patients (85% male) treated with ≥20 fractions of radiation (mean dose = 64.8 Gy delivered over 31.9 fractions) at an Australian tertiary hospital.

Results
Regarding guideline adherences, 80% of patients were seen by a dietitian weekly during treatment and 62% of patients were seen bi-weekly for six-weeks post-treatment. Average weight loss was 6.7% during treatment and 10.3% three-months post treatment. At the end of treatment, oropharyngeal and oral cavity patients had lost the most weight (8.8, 10.9%), with skin cancer and laryngeal patients losing the least weight (4.8, 2.9%). Gastrostomy patients (n = 60) had their tube in-situ for an average of 150 days and lost an average of 7.7 kg (9.4%) during treatment and 11.5 kg (13.5%) from baseline to three-months post treatment. The number of malnourished patients increased from 15% at baseline to 56% at the end of treatment, decreasing to 30% three-months post treatment.

Conclusions
Despite high adherence to evidenced-based guidelines, large discrepancies in weight loss and nutritional status between tumor sites was seen. This highlights the opportunity for further investigation of the relationship between tumor site, nutritional status and nutrition interventions, which may then influence future evidenced-based guidelines.
Original languageEnglish
Article number6
JournalCancers of the Head & Neck
Volume3
DOIs
Publication statusPublished - 31 Jul 2018

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Head and Neck Neoplasms
Guidelines
Therapeutics
Weight Loss
Nutritional Status
Radiation
Guideline Adherence
Weights and Measures
Nutrition Policy
Gastrostomy
Nutritionists
Skin Neoplasms
Tertiary Care Centers
Malnutrition
Mouth
Neoplasms
Cohort Studies
Retrospective Studies

Cite this

@article{4942fbe1e7754fc69fd33669df7034a2,
title = "Investigating adherence to Australian nutritional care guidelines in patients with head and neck cancer",
abstract = "BackgroundSignificant weight loss and malnutrition are common in patients with head and neck cancer, despite advances in treatment and development of evidenced-based guidelines. The aim of this study was to assess adherence to evidenced-based guidelines and investigate nutrition outcomes during and post radiation treatment in head and neck cancer patients.MethodsThis was a two-year retrospective cohort study of 209 head and neck cancer patients (85{\%} male) treated with ≥20 fractions of radiation (mean dose = 64.8 Gy delivered over 31.9 fractions) at an Australian tertiary hospital.ResultsRegarding guideline adherences, 80{\%} of patients were seen by a dietitian weekly during treatment and 62{\%} of patients were seen bi-weekly for six-weeks post-treatment. Average weight loss was 6.7{\%} during treatment and 10.3{\%} three-months post treatment. At the end of treatment, oropharyngeal and oral cavity patients had lost the most weight (8.8, 10.9{\%}), with skin cancer and laryngeal patients losing the least weight (4.8, 2.9{\%}). Gastrostomy patients (n = 60) had their tube in-situ for an average of 150 days and lost an average of 7.7 kg (9.4{\%}) during treatment and 11.5 kg (13.5{\%}) from baseline to three-months post treatment. The number of malnourished patients increased from 15{\%} at baseline to 56{\%} at the end of treatment, decreasing to 30{\%} three-months post treatment.ConclusionsDespite high adherence to evidenced-based guidelines, large discrepancies in weight loss and nutritional status between tumor sites was seen. This highlights the opportunity for further investigation of the relationship between tumor site, nutritional status and nutrition interventions, which may then influence future evidenced-based guidelines.",
author = "Sophie Hofto and Jessica Abbott and James Jackson and Elisabeth Isenring",
year = "2018",
month = "7",
day = "31",
doi = "10.1186/s41199-018-0033-9",
language = "English",
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journal = "Cancers of the Head & Neck",
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Investigating adherence to Australian nutritional care guidelines in patients with head and neck cancer. / Hofto, Sophie; Abbott, Jessica; Jackson, James; Isenring, Elisabeth.

In: Cancers of the Head & Neck, Vol. 3, 6, 31.07.2018.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Investigating adherence to Australian nutritional care guidelines in patients with head and neck cancer

AU - Hofto, Sophie

AU - Abbott, Jessica

AU - Jackson, James

AU - Isenring, Elisabeth

PY - 2018/7/31

Y1 - 2018/7/31

N2 - BackgroundSignificant weight loss and malnutrition are common in patients with head and neck cancer, despite advances in treatment and development of evidenced-based guidelines. The aim of this study was to assess adherence to evidenced-based guidelines and investigate nutrition outcomes during and post radiation treatment in head and neck cancer patients.MethodsThis was a two-year retrospective cohort study of 209 head and neck cancer patients (85% male) treated with ≥20 fractions of radiation (mean dose = 64.8 Gy delivered over 31.9 fractions) at an Australian tertiary hospital.ResultsRegarding guideline adherences, 80% of patients were seen by a dietitian weekly during treatment and 62% of patients were seen bi-weekly for six-weeks post-treatment. Average weight loss was 6.7% during treatment and 10.3% three-months post treatment. At the end of treatment, oropharyngeal and oral cavity patients had lost the most weight (8.8, 10.9%), with skin cancer and laryngeal patients losing the least weight (4.8, 2.9%). Gastrostomy patients (n = 60) had their tube in-situ for an average of 150 days and lost an average of 7.7 kg (9.4%) during treatment and 11.5 kg (13.5%) from baseline to three-months post treatment. The number of malnourished patients increased from 15% at baseline to 56% at the end of treatment, decreasing to 30% three-months post treatment.ConclusionsDespite high adherence to evidenced-based guidelines, large discrepancies in weight loss and nutritional status between tumor sites was seen. This highlights the opportunity for further investigation of the relationship between tumor site, nutritional status and nutrition interventions, which may then influence future evidenced-based guidelines.

AB - BackgroundSignificant weight loss and malnutrition are common in patients with head and neck cancer, despite advances in treatment and development of evidenced-based guidelines. The aim of this study was to assess adherence to evidenced-based guidelines and investigate nutrition outcomes during and post radiation treatment in head and neck cancer patients.MethodsThis was a two-year retrospective cohort study of 209 head and neck cancer patients (85% male) treated with ≥20 fractions of radiation (mean dose = 64.8 Gy delivered over 31.9 fractions) at an Australian tertiary hospital.ResultsRegarding guideline adherences, 80% of patients were seen by a dietitian weekly during treatment and 62% of patients were seen bi-weekly for six-weeks post-treatment. Average weight loss was 6.7% during treatment and 10.3% three-months post treatment. At the end of treatment, oropharyngeal and oral cavity patients had lost the most weight (8.8, 10.9%), with skin cancer and laryngeal patients losing the least weight (4.8, 2.9%). Gastrostomy patients (n = 60) had their tube in-situ for an average of 150 days and lost an average of 7.7 kg (9.4%) during treatment and 11.5 kg (13.5%) from baseline to three-months post treatment. The number of malnourished patients increased from 15% at baseline to 56% at the end of treatment, decreasing to 30% three-months post treatment.ConclusionsDespite high adherence to evidenced-based guidelines, large discrepancies in weight loss and nutritional status between tumor sites was seen. This highlights the opportunity for further investigation of the relationship between tumor site, nutritional status and nutrition interventions, which may then influence future evidenced-based guidelines.

U2 - 10.1186/s41199-018-0033-9

DO - 10.1186/s41199-018-0033-9

M3 - Article

VL - 3

JO - Cancers of the Head & Neck

JF - Cancers of the Head & Neck

SN - 2059-7347

M1 - 6

ER -