[High caloric parenteral nutrition in patients with mouth and oropharyngeal cancers--a clinical study].
Patients with carcinomas of the oral cavity and oropharynx often show signs of malnutrition. This is caused by reduced intake in patients due to chronic alcoholism resulting in suppressed appetite and disturbed gastrointestinal functions. Also the growth of the tumor can cause painful swallowing. The effects of chronic malnutrition reduce patients tolerance regarding surgical treatment, chemotherapy and radiation. A pretherapeutic parenteral balanced nutrition should achieve an anabolic metabolism. Changes in body cell mass (bcm) as a parameter of total protein synthesis can be estimated by bioelectrical impedance analysis in order to prove the success of this management. Twenty-eight patients participated in this study, divided into three groups: group 1 = 18 male subjects and group 3 = 3 female subjects, all able to be operated upon, and group 2 = 7 male subjects, not able to be operated. High caloric nutrition in group 1 lead to a higher increase of bcm than in group 2. The review of single cases showed that in both groups one part of the patients failed increasing bcm despite nutrition. The therapeutic response was correlated to survival by means of a Kaplan-Meier analysis and a Cox-model. Survival probability could positively be correlated to an increased bcm.
Klein
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Abteilung für Mund-, Kiefer- und Gesichtschirurgie, Johann-Wolfgang-Goethe-Universität Frankfurt am Main.
Howaldt
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HP
Frenz
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Klein
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D000328:Adult; D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D003131:Combined Modality Therapy; D017097:Electric Impedance; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D010289:Parenteral Nutrition, Total / Q000379:methods*; D014176:Protein Biosynthesis; D016019:Survival Analysis
Parenterale hochkalorische Ernährung bei Patienten mit Mundhöhlen- und Oropharynxkarzinomen--eine klinische Studie.