title: Food restrictions of patients who are undergoing treatment for oral and oropharyngeal cancer.
abstract: OBJECTIVE
  Oral squamous cell carcinoma and its treatment are associated with facial disfigurement and functional inabilities that may lead to malnutrition or under nourishment. This study assessed the incidence of food restrictions in patients undergoing treatment for oral and oropharyngeal cancer.
  
  
  METHODS
  We interviewed 120 patients in two hospitals in São Paulo, Brazil, using a structured food frequency questionnaire comprising the most commonly consumed foods in Brazil. This questionnaire was applied twice; the first time to inform dietary patterns prior to the diagnosis of cancer and the second time to assess recent modifications of diet that were associated with the disease and its treatment. Hospital files provided information on clinical status. Multivariate Poisson regression models assessed covariates with prognostic value.
  
  
  RESULTS
  One third of patients suffered major food restrictions (i.e., they reduced substantially the intake of more than 50% of the most commonly consumed food items before the diagnosis); 39% suffered a less severe condition (they could not eat less than 50% of the most commonly consumed food items before the diagnosis, and they needed changes in food preparation). Larger tumour size (adjusted incidence ratio IR = 1.45), posterior location (IR = 1.33), radiotherapy (IR = 1.84), loss of tongue mobility (IR = 1.36) and loss of teeth (IR = 1.25) in the surgery were associated significantly with the study outcome.
  
  
  CONCLUSIONS
  This study identified clinical predictors of food restrictions in patients undergoing treatment for oral and oropharyngeal cancer. This knowledge may contribute to improve patient care and management, and to develop interventions aimed at preventing nutritional depletion of these patients.
authors.affiliation: Faculdade de Odontologia da Universidade de São Paulo, Brazil.
authors.forename: Erika de Paula
authors.initials: Ede P
authors.lastname: da Cruz
authors.forename: Tatiana Natasha
authors.initials: TN
authors.lastname: Toporcov
authors.forename: Ligia Drovandi Braga
authors.initials: LD
authors.lastname: Rotundo
authors.forename: Maria Gabriela Haye
authors.initials: MG
authors.lastname: Biazevic
authors.forename: Rosana Sarmento
authors.initials: RS
authors.lastname: Brasileiro
authors.forename: Marcos Brasilino
authors.initials: MB
authors.lastname: de Carvalho
authors.forename: Luiz Paulo
authors.initials: LP
authors.lastname: Kowalski
authors.forename: José Leopoldo Ferreira
authors.initials: JL
authors.lastname: Antunes
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil; D002294:Carcinoma, Squamous Cell / Q000451:nursing / Q000503:physiopathology* / Q000628:therapy; D004435:Eating; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000451:nursing / Q000503:physiopathology* / Q000628:therapy; D009752:Nutritional Status; D009959:Oropharyngeal Neoplasms / Q000451:nursing / Q000503:physiopathology* / Q000628:therapy; D016012:Poisson Distribution; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires