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Nutrition in acute and chronic diseases

Adequacy of nutritional support using computed tomography (CT) in patients with head and neck cancer (HNC) during chemo-radiotherapy (CRT)

European Journal of Clinical Nutrition volume 75, pages 1515–1519 (2021)Cite this article

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Abstract

We assessed forty HNC patients receiving treatment with curative intent. Specific quantitative muscle and fat changes were evaluated using CT. Nutrition support was provided according to ESPEN guidelines, with adjusted body weight (ABW) in overweight/obese patients used to define their nutritional targets. Linear regression models were used to evaluate clinical predictors of tissue loss. Mean overall losses were body weight (−10.5%), and CT-defined muscle (−8.4%) and fat mass (−24.8%), p < 0.001. A subset of 20 patients had high muscle loss (−14.7%) with concurrent negative energy balance as reflected by considerable fat loss (−29.7%); those tended to have higher baseline body mass index (26.2 vs. 23.3 kg/m2, p = 0.063). In multivariate regression, only ABW independently predicted muscle loss (p < 0.001) and fat loss (p = 0.002). Nutrition support according to guidelines was appropriate for a subset of patients. ABW use to set nutrition targets in overweight/obese patients would appear to be insufficient, based on large tissue losses.

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Acknowledgements

We thank Maria Sospedra and Regina González-Tampán from the clinical nutrition unit for their scientific and technical assistance. We acknowledge the Head and Neck Cancer Unit (Bellvitge University Hospital-Catalan Institute of Oncology (HUB-ICO)) for patient recruitment and for taking dietitians as part of the multidisciplinary team.

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Author notes

  1. These authors contributed equally: Baracos Vickie, Mesia Ricard

Authors and Affiliations

  1. Clinical Nutrition Unit, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain

    Lorena Arribas, Laura Hurtós & Inmaculada Peiró

  2. Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain

    Lorena Arribas, Aida Sabaté-Llobera, Miren Taberna, Nuria Virgili, Laura Hurtós, Inmaculada Peiró, Alicia Lozano & Ricard Mesia

  3. Head and Neck Cancer Unit, Bellvitge University Hospital, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain

    Lorena Arribas, Miren Taberna, Esther Vilajosana, Alicia Lozano & Ricard Mesia

  4. University of Barcelona, Barcelona, Spain

    Lorena Arribas & Nuria Virgili

  5. Department of Nuclear Medicine, PET Unit—IDI, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain

    Aida Sabaté-Llobera

  6. Medical Oncology Department, Catalan Institute of Oncology (ICO), ONCOBELL, L’Hospitalet de Llobregat, Barcelona, Spain

    Miren Taberna & Esther Vilajosana

  7. Unitat de Bioestadística (UBiDi), Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain

    Natalia Pallarés

  8. Medical Oncology Deparment, Alava University Hospital, Vitoria, Spain

    Alicia Narro Marin

  9. Nutrition and Dietetics Unit, Endocrinology and Nutrition Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain

    Nuria Virgili

  10. Radiation Oncology Department, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain

    Alicia Lozano

  11. Division of Palliative Care Medicine, Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada

    Vickie Baracos

  12. Medical Oncology Department, Catalan Institute of Oncology (ICO)—Badalona, B-ARGO group, Barcelona, Spain

    Ricard Mesia

Authors
  1. Lorena Arribas
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  2. Aida Sabaté-Llobera
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  3. Miren Taberna
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  6. Nuria Virgili
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  7. Laura Hurtós
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  8. Inmaculada Peiró
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  9. Esther Vilajosana
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  11. Vickie Baracos
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Correspondence to Lorena Arribas.

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Arribas, L., Sabaté-Llobera, A., Taberna, M. et al. Adequacy of nutritional support using computed tomography (CT) in patients with head and neck cancer (HNC) during chemo-radiotherapy (CRT). Eur J Clin Nutr 75, 1515–1519 (2021). https://doi.org/10.1038/s41430-021-00863-z

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  • DOI: https://doi.org/10.1038/s41430-021-00863-z

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