Nesemeier Ryan, Dunlap Neal, McClave Stephen A, Tennant Paul
1Department of Otolaryngology-Head and Neck Surgery, University of Louisville, 529 S Jackson St., 3rd Floor, Louisville, KY 40202 USA.
2Department of Radiation Oncology, University of Louisville, Louisville, KY USA.
Curr Surg Rep. 2017;5(8):18. doi: 10.1007/s40137-017-0179-0. Epub 2017 Jul 6.
Patients diagnosed with head and neck (H&N) cancer often present in a malnourished state for varied reasons; nutritional optimization is therefore critical to the success of treatment for these complex patients. This article aims to review the current nutrition literature pertaining to H&N cancer patients and to present evidence-based strategies for nutritional support specific to this population.
Aggressive nutritional intervention is frequently required in the H&N cancer patient population. Rehabilitating nutrition during operative and nonoperative treatment improves compliance with treatment, quality of life, and clinical outcomes. When and whether to establishing alternative enteral access are points of controversy, although recent evidence suggests prophylactic enteral feeding tube placement should not be universally applied. Perioperative nutritional optimization including preoperative carbohydrate loading and provision of arginine-supplemented immunonutrition has been shown to benefit at-risk H&N cancer patients.
With multidisciplinary collaboration, H&N cancer patients can receive individualized nutritional support to withstand difficult cancer treatment regimens and return to acceptable states of nutritional health.
因各种原因,被诊断为头颈部(H&N)癌症的患者常处于营养不良状态;因此,营养优化对于这些复杂患者的治疗成功至关重要。本文旨在回顾当前与H&N癌症患者相关的营养文献,并提出针对该人群的基于证据的营养支持策略。
H&N癌症患者群体经常需要积极的营养干预。在手术和非手术治疗期间恢复营养可提高治疗依从性、生活质量和临床结局。何时以及是否建立替代肠内通路存在争议,尽管最近的证据表明预防性放置肠内喂养管不应普遍应用。围手术期营养优化,包括术前碳水化合物负荷和提供补充精氨酸的免疫营养,已被证明对有风险的H&N癌症患者有益。
通过多学科协作,H&N癌症患者可以获得个性化的营养支持,以承受艰难的癌症治疗方案,并恢复到可接受的营养健康状态。