Endoscopy Unit, Department of Surgery, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
Department of Surgery, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
Oral Oncol. 2017 Nov;74:135-141. doi: 10.1016/j.oraloncology.2017.10.001. Epub 2017 Oct 9.
Head and neck cancer patients commonly suffer from severe malnutrition at the time of tentative diagnosis. Percutaneous Endoscopic Gastrostomy [PEG] feeding is now considered as an efficient tool to reduce nutritional deterioration alongside concurrent treatment. We undertook the challenge to retrospectively evaluate the impact of a commercial, disease-specific, feeding formula [Supportan, Fresenius Kabi, Hellas] versus blenderized family food on nutritional outcome.
This is a retrospective analysis of prospectively collected nutritional and anthropometric data at the time of PEG placement, at the 8th week [after treatment termination] and at 8 months [6mo of recovery from treatment]. All patients were prescribed a commercial feeding formula.
The final dataset included 212 patients: 112 received the commercial formula, 69 voluntarily decided to switch into blenderized-tube-feeding, and 31 were prescribed to receive a home-made formula of standard ingredients. The commercial formula seemed to help patients to fight the catabolism of concurrent treatment, since, at the 8mo assessment, both Body Mass index and Fat Free Mass had almost recovered to the values at the time of first diagnosis. Neither group on blenderized or home-made formulas exhibited nutritional improvement, but experienced a significant deterioration throughout the study period, with the home-made formula group being the worst.
These findings clearly indicate that home-made and blenderized foods do not adequately support the nutritional requirements of patients with HNC scheduled to receive concurrent CRT treatment.
头颈部癌症患者在初步诊断时通常患有严重的营养不良。经皮内镜下胃造口术(PEG)喂养现在被认为是一种有效的工具,可以在进行同步治疗的同时减少营养恶化。我们承担了一项挑战,即回顾性评估一种商业的、特定于疾病的、配方饮食[Supportan,Fresenius Kabi,希腊]与混合家庭食品对营养结果的影响。
这是一项前瞻性收集的营养和人体测量数据的回顾性分析,包括 PEG 放置时、治疗结束后第 8 周和治疗结束后 8 个月[治疗恢复后 6 个月]。所有患者均被规定使用商业配方饮食。
最终数据集包括 212 名患者:112 名患者接受了商业配方,69 名患者自愿决定转换为混合管饲喂养,31 名患者被规定使用标准成分的自制配方。商业配方似乎有助于患者对抗同步治疗的分解代谢,因为在第 8 个月评估时,体重指数和去脂体重几乎恢复到首次诊断时的值。无论是接受混合配方还是自制配方的患者,在整个研究期间都没有出现营养改善,反而出现了显著的恶化,其中自制配方组的情况最差。
这些发现清楚地表明,自制和混合食物不能充分满足接受同步 CRT 治疗的头颈部癌症患者的营养需求。