title: Nutritional counselling and oral nutritional supplements in head and neck cancer patients undergoing chemoradiotherapy.
abstract: BACKGROUND
  The role of nutritional counselling (NC) with or without oral nutritional supplements (ONS) in patients receiving chemoradiotherapy (CRT) for head and neck cancer (HNC) still remains to be clearly defined, particularly with regard to CRT-related toxicity.
  
  
  METHODS
  Patients undergoing CRT for HNC received NC by the dietitian within the first 4 days of radiotherapy and weekly for the course of radiotherapy (approximately 6 weeks). A weekly supply of oral nutrition supplements [1560 kJ (373 kcal) per 100 g] for up to 3 months was provided to all patients.
  
  
  RESULTS
  Twenty-one patients completed CRT. Mucositis G3 developed in seven (33.3%) patients, whereas mucositis G4 was absent. Dysphagia was present before the start of treatment in four patients. In the remaining 17 patients, dysphagia G3 developed during/at the end of treatment in five cases. The percentage of patients interrupting anti-neoplastic treatment for was 28% for ≥6 days, 28% for 3-5 days and 44% for 0-2 days. Mucositis G3 frequency was lower in patients with a baseline body mass index (BMI, kg m(-2) ) ≥25 (two out of 12; 16.6%) than in patients with BMI <25 (five out of nine; 55.5%) (P = 0.161) and in patients with a baseline mid arm circumference >30 cm than in those with a mid arm circumference in the range 28.1-30 cm and <28 cm, and higher in patients with a greater weight loss and a greater reduction of serum albumin and mid arm circumference.
  
  
  CONCLUSIONS
  Nutritional counselling and ONS are associated with relatively low CRT-related toxicity and with mild deterioration of nutritional parameters.
authors.affiliation: Division of Radiotherapy, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Valentini
authors.forename: F
authors.initials: F
authors.lastname: Marazzi
authors.forename: M
authors.initials: M
authors.lastname: Bossola
authors.forename: F
authors.initials: F
authors.lastname: Miccichè
authors.forename: L
authors.initials: L
authors.lastname: Nardone
authors.forename: M
authors.initials: M
authors.lastname: Balducci
authors.forename: N
authors.initials: N
authors.lastname: Dinapoli
authors.forename: P
authors.initials: P
authors.lastname: Bonomo
authors.forename: R
authors.initials: R
authors.lastname: Autorino
authors.forename: S
authors.initials: S
authors.lastname: Silipigni
authors.forename: F
authors.initials: F
authors.lastname: Giuliani
authors.forename: C
authors.initials: C
authors.lastname: Tamanti
authors.forename: M C
authors.initials: MC
authors.lastname: Mele
authors.forename: G E
authors.initials: GE
authors.lastname: Martorana
mesh_terms: D059248:Chemoradiotherapy / Q000009:adverse effects*; D003131:Combined Modality Therapy; D003376:Counseling; D019587:Dietary Supplements; D004046:Dietetics / Q000379:methods*; D004750:Enteral Nutrition; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome