Adherence to intensive nutrition care in head and neck cancer patients undergoing radiotherapy

Archives of oto-rhino-laryngology - 2021
Sheilla de Oliveira Faria1,2,3, Doris Howell3,1, André Lopes Carvalho4, Rafael de Oliveira Faria5, José Eluf Neto2
1Princess Margaret Cancer Centre Research Institute, Toronto, Canada
2Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
3Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
4Head and Neck Surgery, Barretos Cancer Hospital, Barretos, Brazil
5Departamento de Engenharia Agrícola, Universidade Federal de Lavras, Lavras, Brazil

Tóm tắt

The aim of this study was to determine the prevalence and effect of adherence to intensive nutritional care on nutritional outcomes and survival in head and neck cancer patients undergoing radiotherapy. Three-hundred and seventeen head and neck cancer patients referred to intensive nutrition support during radiotherapy were retrospectively analyzed. Patients who missed less than 25% of their appointments with the dietitian were considered adherent. Primary outcome was percentage weight loss during treatment. Secondary outcomes were overall survival and patients' capacity to accomplish their caloric and protein recommendations. Logistic regression was used to examine predictors of weight loss and Kaplan–Meier to estimate survival. Less than half of the patients (n = 145, 45.7%) were adherent. Statistically significant less weight loss in the adherent group (42.8% vs 55.8%; p = 0.02) was found, despite no difference in energy or protein intake. Logistic regression models after adjusting for other variables demonstrated that adherence resulted in 43% protection from significant weight loss (odds ratio 0.57, 95% CI 0.34–0.97). Overall survival was not different between groups. Findings demonstrated that patients who were adherent to weekly contacts with the dietitian had less weight loss, but not better survival or nutritional intake. Additional investigation of factors that may act as barriers or enablers for adherence could help improve the outcomes in this population.

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