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

Sophie Hofto; Jessica Abbott; James Jackson; Elisabeth Isenring

doi:10.1186/s41199-018-0033-9

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

Sophie Hofto
, Jessica Abbott
, James Jackson
, Elisabeth Isenring

Research output: Contribution to journal › Article › Research › peer-review

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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 language	English
Article number	6
Journal	Cancers of the Head & Neck
Volume	3
DOIs	https://doi.org/10.1186/s41199-018-0033-9
Publication status	Published - 31 Jul 2018

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 2 Zero Hunger
SDG 3 Good Health and Well-being

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10.1186/s41199-018-0033-9Licence: CC BY

Investigating adherence to Australian nutritional care guidelines in patients with head and neck cancerFinal published version, 414 KBLicence: CC BY

2 Active

Oncology Nutrition Research
Isenring, E. (Project Lead), Marshall, S. (Senior Research Fellow), Van der Meij, B. (Senior Research Fellow), Rigby, R. (Associate Investigator), Teleni, L. (HDR Student), Crichton, M. (HDR Student) & Tang, X. (Admin)
1/01/14 → …
Project: Research
Research by Master of Nutrition and Dietetic Practice Students
Isenring, E. (Supervisor), Marshall, S. (Supervisor), Reidlinger, D. (Project Lead), Kelly, J. (Supervisor), Cox, G. (Supervisor), Van der Meij, B. (Supervisor), MacKenzie-Shalders, K. (Supervisor), Mayr, H. (Supervisor), Utter, J. (Associate Professor), Dahl, C. (Masters by Coursework Student), Crichton, M. (Masters by Coursework Student), O'Bryan, K. R. (Masters by Coursework Student), Norris, R. (Masters by Coursework Student), Fahey, M. (Masters by Coursework Student), Davidson, A. (Masters by Coursework Student), Naranjo, A. (Masters by Coursework Student), Mahoney, S. (Masters by Coursework Student), Eberhardt, F. (Masters by Coursework Student), Dalwood, P. (Masters by Coursework Student), Lopez, E. (Masters by Coursework Student), Hofto, S. (Masters by Coursework Student), Innerarity, C. (Masters by Coursework Student), So, D. (Masters by Coursework Student), McIntosh, A. (Masters by Coursework Student), Gadd, N. (Masters by Coursework Student), Chan, H. C. (Masters by Coursework Student), Lan, X. (Masters by Coursework Student), Fei, X. (Masters by Coursework Student), Kostjasyn, S. (Masters by Coursework Student), Adhyaru, P. (Masters by Coursework Student), Giang, J. (Masters by Coursework Student), Leung, E. L. Y. (Masters by Coursework Student), Strike, K. (Project Roles), Pearcy, J. (Masters by Coursework Student), Somani, A. (Masters by Coursework Student), Wright, C. (Masters by Coursework Student), Matthews, C. (Masters by Coursework Student), Lee, G. (Masters by Coursework Student), Tang, X. (Associate Investigator) & Eso, A. (Associate Investigator)
1/01/14 → 31/12/27
Project: Research

Cite this

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title = "Investigating adherence to Australian nutritional care guidelines in patients with head and neck cancer",

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.",

author = "Sophie Hofto and Jessica Abbott and James Jackson and Elisabeth Isenring",

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doi = "10.1186/s41199-018-0033-9",

language = "English",

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journal = "Cancers of the Head \& Neck",

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Y1 - 2018/7/31

N2 - 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.

AB - 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.

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DO - 10.1186/s41199-018-0033-9

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JO - Cancers of the Head & Neck

JF - Cancers of the Head & Neck

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ER -

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

Abstract

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Oncology Nutrition Research

Research by Master of Nutrition and Dietetic Practice Students

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