Systematic Review of Nutrition Interventions to Improve Short Term Outcomes in Head and Neck Cancer Patients

Simple Summary Head and neck cancer (HNC) patients are at increased risk of malnutrition prior to and during radiation, chemotherapy, and surgical treatment. Nutrition intervention is recommended by several organizations, but is not part of treatment guidelines. We conducted a systematic review of randomized controlled trials in HNC patients to determine whether nutrition interventions prevented weight loss, and improved quality of life, nutrient intake, and treatment tolerance. Interventions, including medical nutrition therapy provided by a registered dietitian and including oral nutrition supplements, had the most favorable outcomes in these patients. Head and neck cancer (HNC) is associated with high rates of malnutrition. We conducted a systematic review and descriptive analysis to determine the effects of nutrition interventions on the nutrition status, quality of life (QOL), and treatment tolerance of HNC patients. PubMed, Web of Science, and Embase were searched to include all potentially relevant studies published between 2006-2022. Meta-analysis was not conducted due to heterogeneity of study designs and outcomes reported. Studies were categorized as nutrition interventions: (1) with oral nutrition supplements (ONS) and medical nutrition therapy (MNT) delivered by an RD; (2) with enteral nutrition (EN) support and MNT delivered by an RD; (3) with motivational interviewing and no ONS or EN; and (4) with ONS and no RD. Seven articles met inclusion criteria. Studies measured outcomes from immediately following treatment to 12 months post-treatment. Interventions resulted in benefits to lean mass/weight maintenance (three studies), QOL (two studies), nutrient intake adequacy (one study) and treatment tolerance (two studies). Nutrition counseling by a registered dietitian leads to improved nutrition status and QOL. Further research is needed to determine best practices related to timing of initiation, duration of nutrition intervention, as well as frequency of dietitian follow-up.