PhilSPEN Online Journal of Parenteral and Enteral Nutrition

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(Article 104 | POJ_0098)

Submitted Abstracts

PENSA 2017 Congress

Submitted: August 12, 2017

Abstract ID = 68 | Classification: (5) - Enteral nutrition

Title: Enteral nutrition for patients with head and neck cancer - Consensus statement of the Gastroenterological Society of Taiwan

Author(s): Wei-Kuo Chang (1), Yueh-Hsia Kuo (2), Hsin-Chun Feng (2), Pei-Wei Shueng (3), Muh-Hwa Yang (4), Pei-Jen Lou5, Bor-Shyang Sheu (6), Ming-Shiang Wu (7), Jaw-Town Lin (8)

Institutions represented:

  1. Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;
  2. Department of Dietetics and Nutrition, National Taiwan University Hospital, Taipei, Taiwan;
  3. Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan;
  4. Division of Hematology-Oncology, Department of Medicine, Taipei Veterans General Hospital, Taiwan;
  5. Department of Otolaryngology, College of Medicine, National Taiwan University, Taipei, Taiwan;
  6. Departments of Institute of Clinical Medicine and Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;
  7. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan;
  8. School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan

Keywords: head and neck cancer, HNC, enteral nutrition, consensus, malnutrition

Background: Head and neck cancer (HNC) therapy is the area of medicine with rapidly advances that can improve outcomes for patients. However, patients with HNC are at risk of malnutrition, not only due to physical and metabolic effects of the cancer, but also due to the effects of anticancer therapies.

Objectives: This highlights the need to develop the consensus to improve nutritional care of patients with HNC

Methods: Thirty-one experts of “Upper GI Cancer Nutrition Therapy Consensus” in Taiwan formed the expert group to conduct the consensus conference by a modified Delphi process to vote anonymously to reach a consensus, defined by an agreement of 80% for each statement, and to set the recommendation grade

Results: The consensus included 10 statements to highlight that significant weight loss with malnutrition before treatment determines to poor clinical outcomes of HNC patients. Nutritional interventions significantly benefit clinical outcomes. Prophylactic feeding tube placement is not recommended in patients with good performance and nutritional status. Radiotherapy with or without chemotherapy is an important treatment related factor that causes oral mucositis to limit intake and malnutrition in HNC patients. Administration of glutamine decreases the chemotherapy and radiotherapy induced mucositis in HNC patients. Pre-treatment swallow dysfunction is an important predictor for clinical outcomes and nutritional status of HNC patients. Swallow training is suggested to maintain or improve swallowing function for nutritional intake in HNC patients during or after treatment.

Conclusion: The consensus comprises recommendations to improve enteral nutrition care for HNC patients, especially at high-risk of malnutrition.