Association Between Pretreatment Dietary Preference and Weight Loss after Radiation Therapy in Head and Neck Cancer Patients: A Pilot Study.

Weight loss is common in cancer patients underwent radiation therapy. However, the impact of pretreatment behavior on postradiation nutritional status was unknown. This prospective observational study was conducted in 31 Thai head and neck cancer patients to investigate the association between pretreatment dietary preference and weight change after radiotherapy. Pretreatment preferences on sweet, salty, sour, bitter, umami, spicy, and fatty food were evaluated using a validated questionnaire, TASTE26. Body weights were monitored at baseline, 1,000-2,000, 2,800-3,400, 4,000-4,400, and 5,000-7,000 cGy of radiations and 2 month-follow up after radiotherapy. The energy intakes were analyzed by using 3 day-dietary record and INMUCAL software. Spicy food preference was the only factor found positively correlated with weight loss after radiation (r = 0.64, P = 0.007). Consistently, strong spicy lovers had more pronounced reduction of energy intake and body weight, and higher needs of tube feeding than those of mild or moderate lovers (P < 0.05). This study suggested that stronger preference on spicy food may be associated with less energy intake and more severe weight loss after radiation therapy. A large-scale study is warranted to confirm such findings. Then, preradiation screening for spicy preference may be useful to predict weight loss during radiation therapy.

Nutri-jelly may improve quality of life and decrease tube feeding demand in head and neck cancer patients.

PURPOSE: Eating difficulty is a critical and common problem in head and neck cancer patients undergoing radiotherapy (RT). It leads to poor quality of life and extensive tube feeding use. Nutri-jelly, a food gel with semisolid texture, water-releasing ability, and ready-to-eat by spoon, was recently developed to alleviate the trouble. However, its efficacy was unknown. This study investigated the potential effect of Nutri-jelly on health-related quality of life (HRQOL) and nasogastric tube feeding use. METHODS: A prospective quasi-randomized patients-preference controlled trial was conducted in 74 head and neck cancer patients. Subjects in study and control groups (37 each) had similar baseline HRQOL and body mass index and undergone definitive radiotherapy (25-35 RT fractions, 5,000-7,000 cGy). Only study group received a 200-ml box of Nutri-jelly as daily supplement throughout radiotherapy. HRQOL was scored by validated questionnaires. The use of tube feeding was collected from medical records. RESULTS: From 11 to 35 RT fractions, the study group maintained higher overall HRQOL score than that of control group (p < 0.0001). Multiple physiologic and psychological aspects of HRQOL especially swallowing difficulty and overall eating problems were significantly improved in study as compared to control group. Promisingly, the percentage of tube feeding use in study group (13.5 %) was dramatically lower than control group (48.6 %). CONCLUSIONS: Continuous supplementation of Nutri-jelly throughout radiotherapy may improve HRQOL and reduce tube feeding demand in head and neck cancer patients who preferred to take them. Nutri-jelly could be an alternative for head and neck cancer patients who have eating difficulty during radiotherapy.

Epstein-Barr Virus associated primary intracranial smooth muscle tumor in HIV positive patient: case report and review of the literature.

The authors report a case of HIV-positive patient with primary intracranial smooth muscle tumor Evidence of Epstein-Barr Virus (EB V) infection in this tumor is proven by in situ hybridization for EBV-encoded RNA (EBER). Review of the literature shows that the occurring of smooth muscle tumor at intracranial site is extremely rare and most cases are HIV-infected patient. It also shows an association with EBV infection.