[Effect of an intensive nutritional treatment in nutritional status of head and neck cancer patients in stages III and IV]. / Evaluación del impacto de un tratamiento nutricional intensivo sobre el estado nutricional de pacientes con cáncer de cabeza y cuello en estadio III y IV.

OBJECTIVE: Malnutrition and accelerated weight loss are frequent secondary diagnosis in patients with cancer. Head and neck cancer (H & N Cancer) affects nutritional status because of the tumor type and localization. The aim of the study was to assess the effect of an intensive nutritional treatment (INT) on nutritional status of H & N cancer patients, stages III and IV and to compare that with a historical control whose nutritional treatment was conventional (CT). METHODS: All patients were nutritionally assessed before oncological treatment started (anthropometrical, biochemical, and dietetically). A nutritional feeding plan according to their nutritional personal need was calculated. In case it was impossible to cover all the nutritional requirements orally, a feeding tube was placed. Nutritional follow up was performed each 21 days, during their oncological treatment in four occasions. The results obtained were compared with those obtained from the patients who received the CT that consisted only in nutritional counseling by the attending physician; the statistical test used was Mann Whitney U test. RESULTS: The INT was associated with maintenance of the nutritional status along their oncological treatment. The statistical significant parameters were: weight 55 to 47 kg in the CT group vs 59 a 58 kg in the INT group (p < 0.0001), and hemoglobin: from 13 to 11 g/dl in the CT group vs 14 to 13 g/dl in the INT group (p < 0.002) as the most important ones. In the rest of the data we can observe a clear tendency of increasing the nutrition parameters in patients the INT group, while in the CT group, they showed a persistent decrease. CONCLUSION: We concluded that patients who received the INT as part of their oncological treatment deteriorated less their nutritional status than those who received a CT.

Evaluación del impacto de un tratamiento nutricional intensivo sobre el estado nutricional de pacientes con cáncer de cabeza y cuello en estadio III y IV / Effect of an intensive nutritional treatment in nutritional status of head and neck cancer patients in stages III and IV

Objetivo: La desnutrición y la pérdida acelerada de pesoson frecuentes en pacientes con cáncer. El cáncer de cabeza y cuello (cáncer de C y C) afecta el estado nutricional por la localización y estirpe del tumor. El objetivo fue evaluar el efecto de un tratamiento nutricional intensivo (TNI) sobre el estado nutricional en pacientes con cáncer de C y C en estadiosavanzados y compararlos con un grupo control históricocuyo tratamiento nutricional fue el convencional (TC).Métodos: A todos los pacientes se les realizó una evaluación del estado nutricional al ingreso (antropométrica, bioquímica y dietética). Se calculó un plan de alimentación que cubriera su requerimiento individual. En caso de que no fuera posible cubrir sus requerimientos vía oral se colocó una sonda para alimentación enteral. La evaluación del estado nutricional se realizó durante el tratamiento oncológicocada 21 días (cuatro evaluaciones). Los resultados secompararon el grupo del TC (25 pacientes) que consistió en orientación alimentaria general. El análisis de resultados se llevó a cabo con la prueba no paramétrica U de Mann Whitney. Resultados: El TNI (28 pacientes) se asoció con el mantenimiento del estado nutricional a lo largo del tratamiento oncológico. Los indicadores significativos fueron: cambio de peso 55 a 47 kg en TC contra 59 a 58 kg en TNI (p < 0,0001) y hemoglobina de 13 a 11 g/dl en TC versus 14 a 13,0 g/dl en TNI (p < 0,002) como los más importantes. En el resto de los indicadores se observó una clara tendencia aumentar poco a poco a lo largo del estudio en el grupo del TNI, mientras que en el TC la disminución de los indicadores fue constante.Conclusión:Los pacientes que se reciben un TNI como parteintegral de su tratamiento oncológico deterioraron menos su estado nutricional que aquellos que recibieron el TC

Objective: Malnutrition and accelerated weight loss arefrequent secondary diagnosis in patients with cancer.Head and neck cancer (H & N Cancer) affects nutritionalstatus because of the tumor type and localization. Theaim of the study was to assess the effect of an intensivenutritional treatment (INT) on nutritional status of H &N cancer patients, stages III and IV and to compare thatwith a historical control whose nutritional treatment wasconventional (CT).Methods: All patients were nutritionally assessed before oncological treatment started (anthropometrical,biochemical, and dietetically). A nutritionalfeeding plan according to their nutritional personalneed was calculated. In case it was impossible to cover all the nutritional requirements orally, a feeding tube was placed. Nutritional follow up was performed each 21days, during their oncological treatment in four occasions. The results obtained were compared with thoseobtained from the patients who received the CT that consisted only in nutritional counseling by the attending physician; the statistical test used was Mann Whitney U test.Results: The INT was associated with maintenance of thenutritional status along their oncological treatment. Thestatistical significant parameters were: weight 55 to 47 kg in the CT group vs 59 a 58 kg in the INT group (p <0.0001), and hemoglobin: from 13 to 11 g/dl in the CTgroup vs 14 to 13 g/dl in the INT group (p < 0.002) as the most important ones. In the rest of the data we canobserve a clear tendency of increasing the nutrition parameters in patients the INT group, while in the CT group, they showed a persistent decrease. Conclusion: We concluded that patients who received the INT as part of their oncological treatment deteriorated less their nutritional status than those who received a CT