%0 Journal Article
%T Nutrition Support for Head and Neck Squamous Cell Carcinoma Patients Treated with Chemoradiotherapy: How Often and How Long?
%A Hiroto Ishiki
%A Yusuke Onozawa
%A Takashi Kojima
%A Shuichi Hironaka
%A Akira Fukutomi
%A Hirofumi Yasui
%A Kentaro Yamazaki
%A Keisei Taku
%A Nozomu Machida
%A Narikazu Boku
%A Takayuki Hashimoto
%A Tetsuo Nishimura
%J ISRN Oncology
%D 2012
%R 10.5402/2012/274739
%X Background. Oral intake of many patients with locally advanced head and neck cancer (LAHNC) decrease during chemoradiotherapy (CRT). Although prophylactic percutaneous endoscopic gastrostomy (PEG) is recommended, not a few patients complete CRT without using PEG tube. Patients and Methods. The subjects were patients with LAHNC who received CRT. We retrospectively investigated the incidence and duration of nutritional support during and after CRT, and predicting factors of nutritional support. For patients who required nutritional support, we also checked the day of initiation and the duration of nutritional support. Results. Of 53 patients, 29 patients (55%) required nutritional support during and/or after CRT. While no clear relation between requirement of nutritional support and variables including age, T stage, N stage, clinical stage and chemotherapy regimen, there could be some relationships between tumor primary sites and the requirement and duration of nutritional support. 17 (77%) of 22 patients with oropharynx cancer(OP) required nutritional support and prolonged for 4.4 months, and 11 (46%) of 24 patients with hypopharynx cancer(HP) required nutritional support and prolonged for 21.9 months. Conclusion. Nutritional support is indicated many HNC patients treated with CRT and primary sites may have some relation to its indication and duration. 1. Introduction Chemoradiotherapy (CRT) is one of the treatment choices for locally advanced head and neck squamous cell carcinoma (HNCSCC), not only for patients with unresectable disease, but also for those who desire organ preservation. However, the treatment course is often complicated by the development of painful mucositis, which causes difficulty in oral intake. Furthermore, in some patients, dysphagia occurring as a result of CRT causes life-threatening aspiration pneumonia during and/or after treatment [1, 2]. These obstacles to oral intake often result in treatment failure, prolongation of hospitalization, and treatment-related death [3]. Many physicians have begun to pay more attention to these adverse effects and to developing means to overcome these adverse effects and support the patients¡¯ nutrition during and after CRT [4]. While placement of a percutaneous endoscopic gastrostomy (PEG) or gastric feeding tube (GFT) before CRT is recommended in Western countries, prophylactic placement of a GFT has generally not been accepted in Japan. In addition, some patients do not require nutritional support at all. It would be reasonable to carefully select patients in whom PEG or GFT should be
%U http://www.hindawi.com/journals/isrn.oncology/2012/274739/